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  1. [Monitoring Required for Monitored Anesthesia Care (MAC) and Specific MAC Methodologies].

    Science.gov (United States)

    Suzuki, Toshiyasu

    2015-03-01

    Many physicians responsible for monitored anesthesia care (MAC) are not anesthesiologists and are not acquainted with treatment in response to sudden changes in patient condition. In particular, rapid response and early detection are essential for respiratory depression. Physicians engaged in MAC require pharmacological knowledge regarding sedative and analgesic medications, need to be able to accurately evaluate physiological responses to sedative and anesthetic levels, and need to be acquainted with emergency procedures such as basic life support (BLS) and advanced cardiovascular life support (ACLS). Patient management focusing on both ventilation and oxygenation, through the use of capnography and continuous respiratory monitoring, in addition to oxygenation monitoring using a pulse oximeter, and measuring ECGs and blood pressure in the management of sedated patients, is also important. PMID:26121782

  2. Monitored anesthesia care (MAC sedation: clinical utility of fospropofol

    Directory of Open Access Journals (Sweden)

    Eric A Harris

    2009-12-01

    Full Text Available Eric A Harris, David A Lubarsky, Keith A CandiottiDepartment of Anesthesiology, Perioperative Management, and Pain Medicine, University of Miami/Miller School of MedicineAbstract: Fospropofol, a phosphorylated prodrug version of the popular induction agent propofol, is hydrolyzed in vivo to release active propofol, formaldehyde, and phosphate. Pharmacodynamic studies show fospropofol provides clinically useful sedation and EEG/bispectral index suppression while causing significantly less respiratory depression than propofol. Pain at the injection site, a common complaint with propofol, was not reported with fospropofol; the major patient complaint was transitory perianal itching during the drug’s administration. Although many clinicians believe fospropofol can safely be given by a registered nurse, the FDA mandated that fospropofol, like propofol, must be used only in the presence of a trained anesthesia provider.Keywords: fospropofol, propofol, monitored anesthesia care

  3. A Systematic Review of Factors Associated With Utilization of Monitored Anesthesia Care for Gastrointestinal Endoscopy

    Science.gov (United States)

    Saleh, Ashraf; Rubenstein, Joel H.

    2016-01-01

    Utilization of monitored anesthesia care (MAC) for gastrointestinal endoscopy has increased markedly over the past decade, leading to significant additional health care expenditures. However, the extent to which certain patient-, provider-, and facility-level factors lead to MAC utilization is unclear. A systematic review of 13 studies evaluating influential factors associated with MAC utilization for colonoscopy and/or esophagogastroduodenoscopy was conducted. Multiple studies revealed significant increases in MAC utilization since the early 2000s, with substantial regional variation. The most influential patient-related factors associated with MAC utilization include female sex and diagnostic procedural indication. Other patient-related factors with weaker associations or conflicting evidence include older age, comorbidity, higher patient income, and white/non-Hispanic race. The impact of patient substance use and/or prescription medication use has been minimally studied. The strongest provider- and facility-level factors associated with MAC use are a surgeon endoscopist and nonhospital site of service. Other factors with weaker associations include facility endoscopy volume and endoscopist years of experience. Further qualitative and quantitative health services research is needed to better understand the root cause of the rising trend of MAC utilization and to develop policies for encouraging appropriate use of MAC. PMID:27493596

  4. Anesthesia

    Science.gov (United States)

    ... arm or leg. A common type is epidural anesthesia, which is often used during childbirth. General - makes ... afterwards. Sedation can be used with or without anesthesia. The type of anesthesia or sedation you get ...

  5. The development of pediatric anesthesia and intensive care in Scandinavia

    DEFF Research Database (Denmark)

    Nilsson, Krister; Ekström-Jodal, Barbro; Meretoja, Olli;

    2015-01-01

    created. Scandinavian anesthesia developed slowly. In contrast, Scandinavia pioneered both adult and certainly pediatric intensive care. The pioneers were heavily involved in the teaching and training of anesthetists and nurses. This was necessary to manage the rapidly increasing work. The polio epidemics...

  6. Association of nausea and vomiting in between anaesthetic or patients factors in Monitored Anaesthesia Care (MAC after gastrointestinal endoscopies in tertiary care hospital: An Audit

    Directory of Open Access Journals (Sweden)

    Khalid Maudood Siddiqui

    2012-09-01

    Full Text Available Introduction: Esophagogastroduodenoscopy (EGD is used for both diagnostic and therapeutic procedures. EGD under Monitored Anesthesia Care (MAC is gaining wide acceptance, but nausea and vomiting remains one of the most common and distressing complications, which require additional resources and may delay in the discharge of patient from hospital. The aim of this audit was to determine the association of nausea and vomiting in between anaesthetic technique or patients factors after gastrointestinal endoscopic procedures under MAC. Methods: After finishing 3 hours of endoscopic procedure one of the investigators evaluated and collects the patient’s data in the ward and filled the predesigned assessment form and ticked the different variables which may have effect on nausea and vomiting. Results: 130 patients were enrolled over the period of 1 year. During the all procedure we observed mild to severe nausea vomiting in those patients who have diabetes mellitus and 10 patients were need antiemetic to control vomiting. Conclusion: Incidence of PONV (Postoperative nausea and vomiting is high after endoscopy under MAC especially in those patients who has high risk factors for PONV as well as in known diabetic patients. So prophylactic antiemetic therapy should be commenced in those patients and further randomized controlled trial should be recommended to establish this relationship.

  7. [Risk management in anesthesia and critical care medicine].

    Science.gov (United States)

    Eisold, C; Heller, A R

    2016-06-01

    Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture. The key elements to reduce complications are continuing staff education, algorithms and standard operating procedures (SOP), working according to the principles of crisis resource management (CRM) and last but not least the continuous work-up of mistakes identified by critical incident reporting systems. PMID:27273109

  8. ROLE OF DEXMEDETOMIDINE IN ANESTHESIA AND CRITICAL CARE

    Directory of Open Access Journals (Sweden)

    Baljit Singh

    2014-09-01

    Full Text Available The potential uses of dexmedetomidine (DEX, a highly selective α2- adrenoceptor agonist are very diverse Although not orally active, DEX shows good bioavailability when administered via various other routes like intranasal, buccal, IM than intra-venous. DEX has similar pharmacokinetics in all age groups. Its side effects are predictable and easily treatable; hence it has found a place as a part of fast-tracking anesthesia regimens in children. DEX is the sedative of choice for peri-operative use in high- risk patients, since it is cardioprotective, neuroprotective and renoprotective. Premedication with DEX obtunds the autonomic pressor responses due to laryngoscopy and endotracheal intubation when used as an adjuvant to general anesthesia. DEX in high doses offers another approach to manage morbidly obese patients and patients with a compromised airway; without causing any cardiorespiratory depression. It is near ideal hypotensive agent used for controlled hypotension. Availability of an antidote (Atipamezole with similar elimination half-life is taking the drug into new frontiers .The aim of this review is to present the most recent topics regarding the advantages in using dexmedetomidine in clinical anesthesia and in critical care, while discussing the controversial issues of its harmful effects.

  9. Monitored anesthesia care in a case of pheochromocytoma and atrial myxoma

    OpenAIRE

    Manvikar, Laxmi P.; Adhye, Bharati A.

    2012-01-01

    Anesthesia for a patient with pheochromocytoma is challenging; irrespective of whether it is a diagnosed case for planned surgery or an occult case, it can be a nightmare. The patient may be given anesthesia for removal of the primary tumor or for surgery other than for the removal of the primary tumor. Hemodynamic derangements like hypertension and arrhythmia can be catastrophic. Monitored anesthesia care, though used for many cases, is unusual for a patient with diagnosed pheochromocytoma, ...

  10. Major themes for 2012 in cardiovascular anesthesia and intensive care.

    Science.gov (United States)

    Riha, H; Patel, P; Al-Ghofaily, L; Valentine, E; Sophocles, A; Augoustides, J G T

    2013-01-01

    There was major progress through 2012 in cardiovascular anesthesia and intensive care. Although recent meta-analysis has supported prophylactic steroid therapy in adult cardiac surgery, a large Dutch multicenter trial found no outcome advantage with dexamethasone. A second large randomized trial is currently testing the outcome effects of methyprednisolone in this setting. Due to calibration drift, the logistic EuroSCORE has recently been recalibrated. Despite this model revision, EuroSCORE II still overestimates mortality after transcatheter aortic valve implantation. It is likely that a specific perioperative risk model will be developed for this unique patient population. Recent global consensus has prioritized 12 non-surgical interventions that merit further study for reducing mortality after surgery. There is currently a paradigm shift in the conduct of adult aortic arch repair. Recent advances have facilitated aortic arch reconstruction with routine antegrade cerebral perfusion at mild-to-moderate hypothermia. Further integration of hybrid endovascular techniques may allow future aortic arch repair without hypothermia or circulatory arrest. These advances will likely further improve patient outcomes. PMID:23734284

  11. Use of Articaine in loco-regional anesthesia for day care surgical procedures

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2012-01-01

    Full Text Available The popularity of day case surgical procedures has increased immensely over the last few years. Though various techniques are available for carrying out day-case anesthesia, preference for a technique depends upon the type of procedure, patient profile, associated co-morbidities, available infrastructure and back-up facilities, monitoring devices and comfort of the attending anesthesiologist with the technique. Day-case spinal anesthesia for ambulatory surgery has gained a wider acceptance and numerous drugs are available for use in loco-regional anesthesia. Articaine is one such amide local anesthetic drug which is increasingly being used in day care surgeries. Properties of articaine such as faster onset, shorter elimination time and rapid recovery from sensory and motor blockade make it a very useful agent in local and regional anesthesia for day care surgical procedures. This article aims to review these properties of articaine so as to evaluate how useful articaine can be for ambulatory surgical procedures.

  12. Case Sequencing of Diagnostic Imaging Studies Performed Under General Anesthesia or Monitored Anesthesia Care During Nights and Weekends.

    Science.gov (United States)

    Mueller, Rashmi N; Dexter, Franklin; Truong, Van-Anh; Wachtel, Ruth E

    2015-11-01

    General anesthesia or monitored anesthesia care sometimes is provided in nonoperating room (OR) locations during nights and weekends (e.g., for magnetic resonance imaging [MRI] or computerized tomography [CT]). Rational and consistent scheduling and sequencing decisions for these diagnostic imaging procedures, including coordination with OR cases, cannot be done without knowing how long each case can wait to be started without risking a worsening of the patient's condition. We reviewed the medical records of the 81 patients who underwent diagnostic imaging procedures (78 = MRI, 3 = CT scan) under general anesthesia or monitored anesthesia care either on weekends or between 6 pm and 6 am at the University of Iowa Hospitals between March 2012 and February 2014. For 77.8% of patients, the indications could have changed clinical management within 4 hours (N = 63/81). Among the 63 imaging studies with potential immediate impact, there was documentation of results having been communicated to the treating team within 4 hours of the completion of imaging for 39 of the patients. Among the 39 patients, 15 promptly received medications or underwent procedures based on the imaging results. Thus, 15 of the 81 patients had a change in care (18.5%, 95% lower confidence limit = 11.2%). Our results are important since we showed previously that it is not possible to make rational and consistent decisions in case sequencing without knowing how long each case (including diagnostic imaging procedures) can wait to be started without a change in the patient's risk. The scheduled surgical procedure itself provides sufficient information to assess safe waiting times to start add-on cases (e.g., appendectomy). In contrast, MRI provides no context as to how potential findings will influence treatment. Our results show that the assumption cannot reasonably be made when sequencing cases that all imaging studies can or cannot wait longer than pending surgical procedures. Our results show that

  13. [Managed care. Its impact on health care in the USA, especially on anesthesia and intensive care].

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    Bauer, M; Bach, A

    1998-06-01

    Managed care, i.e., the integration of health insurance and delivery of care under the direction of one organization, is gaining importance in the USA health market. The initial effects consisted of a decrease in insurance premiums, a very attractive feature for employers. Managed care promises to contain expenditures for health care. Given the shrinking public resources in Germany, managed care seems attractive for the German health system, too. In this review the development of managed care, the principal elements, forms of organisation and practical tools are outlined. The regulation of the delivery of care by means of controlling and financial incentives threatens the autonomy of physicians: the physician must act as a "double agent", caring for the interest for the individual patient and being restricted by the contract with the managed care organisation. Cost containment by managed care was achieved by reducing the fees for physicians and hospitals (and partly by restricting care for patients). Only a fraction of this cost reduction was handed over to the enrollee or employer, and most of the money was returned with profit to the shareholders of the managed care organisations. The preeminent role of primary care physicians as gatekeepers of the health network led to a reduced demand for specialist services in general and for university hospitals and anesthesiologists in particular. The paradigm of managed care, i.e., to guide the patient and the care giver through the health care system in order to achieve cost-effective and high quality care, seems very attractive. The stress on cost minimization by any means in the daily practice of managed care makes it doubtful if managed care should be an option for the German health system, in particular because there are a number of restrictions on it in German law. PMID:9676303

  14. Ketofol for monitored anesthesia care in shoulder arthroscopy and labral repair: a case report

    OpenAIRE

    Lee KC; Shi H.; Lee BC

    2016-01-01

    Kevin C Lee,1 Hanyuan Shi,2 Brian C Lee3 1Columbia University College of Dental Medicine, New York, NY, 2Vanderbilt University School of Medicine, Nashville, TN, 3Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA Abstract: A 21-year-old male (body mass index: 28.3) with a history of asthma and reactive airway disease since childhood underwent left shoulder arthroscopy and labral repair surgery under monitored anesthesia care. Because the procedure was perform...

  15. Quantification of hand hygiene compliance in anesthesia providers at a tertiary care center in northern India.

    Science.gov (United States)

    Sahni, Neeru; Biswal, Manisha; Gandhi, Komal; Yaddanapudi, Sandhya

    2015-10-01

    Hand hygiene (HH) compliance continues to remain poor amongst anesthetists mainly because of multitasking and the need for repeated HH. We aimed to quantify HH compliance amongst anesthesia providers while performing anesthesia-related procedures inside operating rooms. The observations for HH before and after procedures, including placement of intravenous cannula, intubation, central line placement, arterial line placement, and neuraxial and peripheral nerve block, were made by a single observer in operating rooms where elective surgeries are carried out. The overall compliance of all health care workers was 39.6%. Resident physicians were less likely to be compliant than consultant physicians and there was significant variation in procedure-related HH with maximum compliance before neuraxial block (100%) followed by arterial line placement (93.7%), central line insertion (86.7%), and peripheral nerve block (80%) (P < .001). The compliance after performing the above procedures was <50% for all procedures. PMID:26159498

  16. Ventriculoperitoneal Shunt Insertion Under Monitored Anesthesia Care in a Patient With Severe Pulmonary Hypertension.

    Science.gov (United States)

    Burbridge, Mark A; Brodt, Jessica; Jaffe, Richard A

    2016-07-15

    A 32-year-old man with severe pulmonary arterial hypertension and Eisenmenger syndrome secondary to congenital ventricular septal defects presented for ventriculoperitoneal shunt insertion. Consultation between surgical and anesthesia teams acknowledged the extreme risk of performing this case, but given ongoing symptoms related to increased intracranial pressure from a large third ventricle colloid cyst, the case was deemed urgent. After a full discussion with the patient, including an explanation of anesthetic expectations and perioperative risks, the case was performed under monitored anesthesia care. Anesthetic management included high-flow nasal cannula oxygen with capnography and arterial blood pressure monitoring, dexmedetomidine infusion, boluses of midazolam and ketamine, and local anesthetic infiltration of the cranial and abdominal incisions as well as the catheter track. Hemodynamic support was provided with an epinephrine infusion, small vasopressin boluses, and inhaled nitric oxide. The patient recovered without any significant problems and was discharged home on postoperative day 3. PMID:27224039

  17. The Degree of Satisfaction of Medical Students Regarding Simulation Based Teaching Methods in Anesthesia and Intensive Care

    OpenAIRE

    Moldovan Cosmin; Szederjesi Janos; Azamfirei Leonard

    2016-01-01

    Background: Anesthesia and Intensive Care is a teaching subject that arguably benefits the most from the use of simulation based methods in education. The availability of technically advanced complex simulators allows instructors to develop training scenarios that can be deeply integrated within the teaching curriculum. Aim: The present study aimed to assess whether the students undergoing Anesthesia and Intensive Caresimulation training are satisfied with the perceived educational outcome. M...

  18. Implementing a regional anesthesia block nurse team in the perianesthesia care unit increases patient safety and perioperative efficiency.

    Science.gov (United States)

    Russell, Rebecca Ann; Burke, Kimberly; Gattis, Katherine

    2013-02-01

    A lack of standardized nursing procedures regarding the management of patients receiving preoperative regional anesthesia in the perianesthesia setting raises a number of issues for perianesthesia nurses. In January 2010, Duke University Hospital's perianesthesia care unit implemented a regional anesthesia "block nurse" team in the preoperative holding area as a patient safety initiative. In January 2011, a retrospective data review was conducted. Results indicated that the implementation of the block nurse team not only increased patient safety but also increased perioperative efficiency and productivity, and decreased delays to operating room start times. This article describes the role of the regional anesthesia block nurse, the development of a block nurse team, and the early benefits of implementing a dedicated regional anesthesia block nurse team in the perianesthesia setting. PMID:23351242

  19. Mac Bible

    CERN Document Server

    Spivey, Dwight

    2009-01-01

    This essential guide answers all your questions on using a Macintosh computer, whether you?re unpacking your very first Mac after switching from a PC or upgrading from an older Mac. You?ll walk through all pre-installed Mac applications, including using Mac OS X, browsing the Web using Safari, downloading music from the iTunes store, troubleshooting Mac-specific problems, organizing photos in iPhoto, organizing calendars in iCal, editing digital video in iMovie, and more.

  20. Anesthesia and critical-care delivery in weightlessness: A challenge for research in parabolic flight analogue space surgery studies

    Science.gov (United States)

    Ball, Chad G.; Keaney, Marilyn A.; Chun, Rosaleen; Groleau, Michelle; Tyssen, Michelle; Keyte, Jennifer; Broderick, Timothy J.; Kirkpatrick, Andrew W.

    2010-03-01

    BackgroundMultiple nations are actively pursuing manned exploration of space beyond low-earth orbit. The responsibility to improve surgical care for spaceflight is substantial. Although the use of parabolic flight as a terrestrial analogue to study surgery in weightlessness (0 g) is well described, minimal data is available to guide the appropriate delivery of anesthesia. After studying anesthetized pigs in a 0 g parabolic flight environment, our group developed a comprehensive protocol describing prolonged anesthesia in a parabolic flight analogue space surgery study (PFASSS). Novel challenges included a physically remote vivarium, prolonged (>10 h) anesthetic requirements, and the provision of veterinary operating room/intensive care unit (ICU) equivalency on-board an aircraft with physical dimensions of medication, and induction protocols on Yorkshire-cross specific pathogen-free (SPF) pigs. Several constant rate infusion (CRI) intravenous anesthetic combinations were tested. In each regimen, opioids were administered to ensure analgesia. Ventilation was supported mechanically with blended gradients of oxygen. The best performing terrestrial 1 g regime was flight tested in parabolic flight for its effectiveness in sustaining optimal and prolonged anesthesia, analgesia, and maintaining hemodynamic stability. Each flight day, a fully anesthetized, ventilated, and surgically instrumented pig was transported to the Flight Research Laboratory (FRL) in a temperature-controlled animal ambulance. A modular on-board surgical/ICU suite with appropriate anesthesia/ICU and surgical support capabilities was employed. ResultsThe mean duration of anesthesia (per flight day) was 10.28 h over four consecutive days. A barbiturate and ketamine-based CRI anesthetic regimen supplemented with narcotic analgesia by bolus administration offered the greatest prolonged hemodynamic stability through an IV route (within multiple transport vehicles and differing gravitational environments

  1. Arterial waveform analysis in anesthesia and critical care: Theory, practical applications, and use in goal-directed strategies

    OpenAIRE

    Montenij, L.J.

    2016-01-01

    Cardiac output and preload are important variables in the hemodynamic optimization of critically ill patients in the operating room and intensive care unit. Arterial waveform analysis (AWA) enables continuous, minimally invasive measurement of CO from an arterial line, and provides dynamic assessment of cardiac preload. The present thesis investigates the theory and current applications of AWA in anesthesia and critical care, explores the methodological challenges in CO method comparison rese...

  2. Changes in circulating blood volume following isoflurane or sevoflurane anesthesia.

    Science.gov (United States)

    Hamada, H; Takaori, M; Kimura, K; Fukui, A; Fujita, Y

    1993-07-01

    Changes of circulating blood volume (CB volume) measured by the dual indicator dilution method were observed in 33 chronically instrumented mongrel dogs following either alpha-chloralose-urethane (C group), additive isoflurane (I group) or sevoflurane anesthesia (S group). These anesthetic groups were each divided into two subgroups with regard to respiratory care, namely Cp, Ip and Sp for those with intermittent positive pressure ventilation (six animals per subgroups), and Cs, Is and Ss for those with spontaneous breathing (five animals per subgroups). The CB volume under positive pressure ventilation remained unchanged in the Ip and Sp groups at both 0.5 and 1.0 MAC, and in the Cp group. The CB volume remained essentially unchanged in the Cs and Is groups at both 0.5 or 1.0 MAC, but the plasma volume tended to increase slightly in the Is group at 1.0 MAC. In the Ss group under spontaneous breathing, however, the CB volume increased from 84.4 +/- 7.0 to 91.4 +/- 7.7 at 0.5 MAC, and to 91.4 +/- 10.2 ml.kg(-1) at 1.0 MAC (0.01 < P < 0.05). These increases were caused by an increase in the plasma volume. The above data suggests that a concomitant increase in the venous pressure associated with an increase in the intrathoracic pressure produced by positive pressure ventilation would attenuate changes in the CB volume during sevoflurane anesthesia. PMID:15278818

  3. The Degree of Satisfaction of Medical Students Regarding Simulation Based Teaching Methods in Anesthesia and Intensive Care

    Directory of Open Access Journals (Sweden)

    Moldovan Cosmin

    2016-03-01

    Full Text Available Background: Anesthesia and Intensive Care is a teaching subject that arguably benefits the most from the use of simulation based methods in education. The availability of technically advanced complex simulators allows instructors to develop training scenarios that can be deeply integrated within the teaching curriculum. Aim: The present study aimed to assess whether the students undergoing Anesthesia and Intensive Caresimulation training are satisfied with the perceived educational outcome. Material and method: We carried out a retrospective transversal study in which we analyzed 256 feedback forms received from medical students between October 2014 and June 2015. The forms contained 5 fixed questions that required rating a certain parameter with grades from 1 to 5. Results: The simulation sessions used in Anesthesia and Intensive Care training were well perceived by students, over 90% of whom considered that these training session are useful from a professional and career development point of view. Conclusion: Based on the students’ perception, simulation training sessions in Anesthesia and Intensive Care can be further developed and integrated with the clinical practical content of this subject.

  4. MacBook for dummies

    CERN Document Server

    Chambers , Mark L

    2014-01-01

    Make friends with your MacBook the fun and easy way! Ultra-light, ultra-fast, and ultra-powerful, the MacBook is the coolest laptop in town, and longtime Mac guru Mark L. Chambers is just the guy to help you get to know your MacBook in no time. Take a closer look at the latest features, get the lowdown on OS X, unleash your creative forces with iLife, take care of business with the iWork applications, and sync it all with iCloud with the expert advice in this bestselling MacBook guide. Whether this is your first MacBook or your first laptop, period, you''ll learn to navigate the Mac desktop, c

  5. Postoperative Residual Curarization: Clinical Observation in the Post-anesthesia Care Unit

    Directory of Open Access Journals (Sweden)

    Ming-Shan Chen

    2008-08-01

    Full Text Available Background: Neuromuscular blocking agents (NMBAs are widely used during the inductionand maintenance of anesthesia. Postoperative residual curarization(PORC following the use of NMBAs still occurs even though intermediateactingNMBAs were used. Train-of-four (TOF stimulation is used to quantifythe degree of neuromuscular blockade. The TOF ratio of 0.7 in the adductorpollicis muscle was associated with normal respiratory function.Pharyngeal function returned to normal while the TOF ratio reached 0.9. Theaim of this study was to survey the PORC in the post-anesthesia care unit(PACU.Methods: In this observational study, 308 patients who received general anesthesiawith NMBAs were enrolled. Residual curarization was evaluated using theTOF-Watch acceleromyograph upon arrival in the PACU. Three consecutiveTOF stimulations were applied and recorded at 15-second intervals. Twothresholds of TOF ratios (0.9 and 0.7 were used to assess the presence ofresidual curarization.Results: TOF ratios less than 0.7 and 0.9 were observed in 15 (5%, and 97 (31%patients, respectively. The differences of the TOF ratios between the maleand female patients were significant (p = 0.014. In terms of weight, the differencesbetween the patients with ratios > 0.9 and ≦ 0.9 were significant (p= 0.013. There were 67, 49, 15, and three patients who received reversalmedication in the > 0.9 group, ≦ 0.9 and > 0.7 group, and ≦ 0.7 group,respectively. The differences of the TOF ratios between the patients whoreceived and those who did not receive reversal medication were not significant(p = 0.91.Conclusion: PORC is still a clinical problem in the modern PACU. Objective neuromuscularmonitoring needs to be performed to ensure patient safety.

  6. Anesthesia Awareness

    Science.gov (United States)

    ... and Anesthesia Smoking and Anesthesia Outpatient Surgery Anesthesia Awareness Very rarely – in only one or two out ... become aware or conscious. The condition – called anesthesia awareness – means the patient can recall the surroundings or ...

  7. Evidence Basis for Regional Anesthesia in Multidisciplinary Fast-Track Surgical Care Pathways

    DEFF Research Database (Denmark)

    Carli, Francesco; Kehlet, Henrik; Baldini, Gabriele; Steel, Andrew; McRae, Karen; Slinger, Peter; Hemmerling, Thomas; Salinas, Francis; Neal, Joseph M.

    2011-01-01

    fast-track methodologies, were identified. The impact of epidural and paravertebral blockade, spinal analgesia, peripheral nerve blocks, and new regional anesthesia techniques on main procedure-specific postoperative outcomes is discussed. Finally, in the last section, implementations required to......Fast-track programs have been developed with the aim to reduce perioperative surgical stress and facilitate patient's recovery after surgery. Potentially, regional anesthesia and analgesia techniques may offer physiological advantages to support fast-track methodologies in different type of...... surgeries. The aim of this article was to identify and discuss potential advantages offerred by regional anesthesia and analgesia techniques to fast-track programs. In the first section, the impact of regional anesthesia on the main elements of fast-track surgery is addressed. In the second section...

  8. Mycobacterium Avium Complex (MAC)

    Science.gov (United States)

    ... Select a Language: Fact Sheet 514 Mycobacterium Avium Complex (MAC) WHAT IS MAC? HOW DO I KNOW ... THE BOTTOM LINE WHAT IS MAC? Mycobacterium Avium Complex (MAC) is a serious illness caused by common ...

  9. A Technical Evaluation of Wireless Connectivity from Patient Monitors to an Anesthesia Information Management System During Intensive Care Unit Surgery.

    Science.gov (United States)

    Simpao, Allan F; Galvez, Jorge A; England, W Randall; Wartman, Elicia C; Scott, James H; Hamid, Michael M; Rehman, Mohamed A; Epstein, Richard H

    2016-02-01

    Surgical procedures performed at the bedside in the neonatal intensive care unit (NICU) at The Children's Hospital of Philadelphia were documented using paper anesthesia records in contrast to the operating rooms, where an anesthesia information management system (AIMS) was used for all cases. This was largely because of logistical problems related to connecting cables between the bedside monitors and our portable AIMS workstations. We implemented an AIMS for documentation in the NICU using wireless adapters to transmit data from bedside monitoring equipment to a portable AIMS workstation. Testing of the wireless AIMS during simulation in the presence of an electrosurgical generator showed no evidence of interference with data transmission. Thirty NICU surgical procedures were documented via the wireless AIMS. Two wireless cases exhibited brief periods of data loss; one case had an extended data gap because of adapter power failure. In comparison, in a control group of 30 surgical cases in which wired connections were used, there were no data gaps. The wireless AIMS provided a simple, unobtrusive, portable alternative to paper records for documenting anesthesia records during NICU bedside procedures. PMID:26797553

  10. 小儿氯胺酮麻醉术后复苏的护理研究%Nursing Care of Postoperative Recovery of Ketamine Anesthesia in Children

    Institute of Scientific and Technical Information of China (English)

    叶红艳

    2014-01-01

    Objective To investigate the nursing experience of children ketamine anesthesia recovery.Methods A total of 196 cases in anesthesia recovery ketamine anesthesia children take careful y ef ective protection Measures, such as strengthening the condition monitoring and safety management.Results 196 cases of children with ketamine anesthesia safety through anesthesia recovery, the effect is bet er.Conclusion For children with ketamine anesthesia and ef ective nursing is beneficial to the safety of anesthesia recovery.%目的探讨小儿氯胺酮麻醉复苏期的护理体会。方法对我院196例处于麻醉复苏期的氯胺酮麻醉患儿采取精心有效的护理措施,如加强病情监测和安全防范的管理。结果196例氯胺酮麻醉患儿安全度过麻醉复苏期,效果较好。结论对氯胺酮麻醉患儿采取精心有效的护理有利于安全度过麻醉复苏期。

  11. Evidence Basis for Regional Anesthesia in Multidisciplinary Fast-Track Surgical Care Pathways

    DEFF Research Database (Denmark)

    Carli, Francesco; Kehlet, Henrik; Baldini, Gabriele;

    2011-01-01

    Fast-track programs have been developed with the aim to reduce perioperative surgical stress and facilitate patient's recovery after surgery. Potentially, regional anesthesia and analgesia techniques may offer physiological advantages to support fast-track methodologies in different type of surge...

  12. Alteration in respiratory physiology in obesity for anesthesia-critical care physician

    OpenAIRE

    Porhomayon, J; Papadakos, P; Singh, A.; Nader, N D

    2011-01-01

    Obesity is known to be a major risk factor of a whole range of cardiovascular, metabolic and respiratory disorders. The pattern of regional fat distribution plays an important role in the pre-disposition of obese subjects to respiratory complications. Obesity is responsible for important changes in respiratory function both during spontaneous breathing as well as during general anesthesia and mechanical ventilation. The most characteristic abnormalities consist of decreased functional residua...

  13. Epidermolysis bullosa: Careful monitoring and no touch principle for anesthesia management

    Directory of Open Access Journals (Sweden)

    Sujit V Saraf

    2013-01-01

    Full Text Available Epidermolysis bullosa (EB is a rare genetic mechanobullous disorder, with excessive fragility of the skin and mucous membranes. Avoiding mechanical injury to the skin and mucous membranes is essential in the anesthetic management. Shearing forces applied to the skin result in bullae formation, while compressive forces to the skin are tolerated. The challenge is to use monitoring technology without damaging the epithelial surface. Difficult airway, positioning issues, nutritional deficiencies, poor immunity, and carcinogenic potential add to the comorbidities. We managed a child with EB undergoing syndactyly release. Ensuring maximal skin and mucous membrane protection, anesthesia in children with EB can be conducted with few sequelae.

  14. Macs portable genius

    CERN Document Server

    McFedries, Paul

    2008-01-01

    You're one of the legions of fans who enjoy the ease and simplicity of the Mac. But some functions still elude you. How do you synch your Mac with other devices? What are the best ways to organize your life and files with your Mac? Can you get more from your Mac hardware or upgrade it? The Portable Genius is here to help. With expert advice and a Mac-savvy attitude, the Macs Portable Genius guides you through getting the most out of your Mac. From the Introduction: ""Welcome to Macs Portable Genius. This book is like a mini Genius Bar all wrapped up in an easy to use, easy

  15. General anesthesia

    Science.gov (United States)

    General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel ... doctor called an anesthesiologist will give you the anesthesia. Sometimes, a certified and registered nurse anesthetist will ...

  16. McGRATH MAC videolaryngoscope versus Macintosh laryngoscope for orotracheal intubation in intensive care patients: the randomised multicentre MACMAN trial study protocol

    Science.gov (United States)

    Bailly, Arthur; Le Thuaut, Aurelie; Boisrame-Helms, Julie; Kamel, Toufik; Mercier, Emmanuelle; Ricard, Jean Damien; Lemiale, Virginie; Champigneulle, Benoit; Reignier, Jean

    2015-01-01

    Introduction Critically ill patients with acute respiratory, neurological or cardiovascular failure requiring invasive mechanical ventilation are at high risk of difficult intubation and have organ dysfunctions associated with complications of intubation and anaesthesia such as hypotension and hypoxaemia. The complication rate increases with the number of intubation attempts. Videolaryngoscopy improves elective endotracheal intubation. McGRATH MAC is the lightest videolaryngoscope and the most similar to the Macintosh laryngoscope. The primary goal of this trial was to determine whether videolaryngoscopy increased the frequency of successful first-pass intubation in critically ill patients, compared to direct view Macintosh laryngoscopy. Methods and analysis MACMAN is a multicentre, open-label, randomised controlled superiority trial. Consecutive patients requiring intubation are randomly allocated to either the McGRATH MAC videolaryngoscope or the Macintosh laryngoscope, with stratification by centre and operator experience. The expected frequency of successful first-pass intubation is 65% in the Macintosh group and 80% in the videolaryngoscope group. With α set at 5%, to achieve 90% power for detecting this difference, 185 patients are needed in each group (370 in all). The primary outcome is the proportion of patients with successful first-pass orotracheal intubation, compared between the two groups using a generalised mixed model to take the stratification factors into account. Ethics and dissemination The study project has been approved by the appropriate ethics committee (CPP Ouest 2, # 2014-A00674-43). Informed consent is not required, as both laryngoscopy methods are considered standard care in France; information is provided before study inclusion. If videolaryngoscopy proves superior to Macintosh laryngoscopy, its use will become standard practice, thereby decreasing first-pass intubation failure rates and, potentially, the frequency of intubation

  17. [Nursing care in the anesthesia recovery period: review of the literature].

    Science.gov (United States)

    de Moraes, Lygia Oliveira; Peniche, Aparecida de Cássia

    2003-12-01

    The present study was undertaken after it was observed that patients submitted to surgical procedures arrived in recovery room with incomplete records, thus complicating continuing nursing care. The goal of the present study is to analyze bibliographic data from 1990 to 2002 on recovery room nursing care. The data was obtained from LILACS (Latin America Literature about Health Science), PERIENF (Nursing School Library of the University of São Paulo) and BDENF (Library of Federal University of Minas Gerais). The key words were nursing care, recovery room and immediate post-operative period. Only 16 articles were found, indicating a shortage of literature on this topic. The recovery room period is an important period of hospitalization and the data are essential for continuous care. PMID:14727442

  18. Inguinal herniorrhaphy under monitored anesthesia care with ilioinguinal-iliohypogastric block: the impact of adding clonidine to ropivacaine.

    Science.gov (United States)

    Beaussier, Marc; Weickmans, Henri; Abdelhalim, Zoubida; Lienhart, André

    2005-12-01

    There is no information concerning the association of ropivacaine and clonidine for ilioinguinal-iliohypogastric block. In this prospective, double-blind study, we randomly assigned 40 adult patients scheduled for inguinal herniorrhaphy under monitored anesthesia care to receive either 225 mg ropivacaine (7.5 mg/mL) alone (control group) or combined with 75 mug clonidine (clonidine group) for preoperative ilioinguinal-iliohypogastric block. After completion of surgery, patients were transferred to the postanesthesia care unit and were asked to stand up and walk around at the second postoperative hour. After leaving the postanesthesia care unit, patients could take oral propacetamol (500 mg) and codeine (30 mg) on request. Pain intensity was assessed with a 100 mm visual analog scale. Time to first request of supplemental analgesics (median [95% confidence interval]) was 10 h (7.1-14.5 h) and 9 h (6.4->24 h) respectively in the clonidine and control groups (P = 0.83). Pain at rest did not differ between groups whereas pain at motion was reduced on the third postoperative day in the clonidine group. More patients who received clonidine experienced orthostatic hypotension upon standing up within the first postoperative hours (6 of 20 versus 1 of 20 in the control group; P < 0.05). In conclusion, the benefit of adding clonidine 75 mug to ropivacaine for ilioinguinal-iliohypogastric block for motion pain on the third postoperative day must be balanced with an increasing risk of orthostatic hypotension in the immediate postoperative period. PMID:16301238

  19. Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal

    Directory of Open Access Journals (Sweden)

    Mercês Lobo

    2015-08-01

    Full Text Available BACKGROUND: Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results.OBJECTIVES: Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality in a tertiary center in Portugal and review the literature.METHODS: Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation.RESULTS: A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregional anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the two groups regarding per operative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference.CONCLUSIONS: We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the two techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers.

  20. Macs for dummies

    CERN Document Server

    Baig, Edward C

    2014-01-01

    Get the most out of your Mac with this comprehensive guide Macs For Dummies, 13th Edition is the ultimate guide to your Mac, fully updated to include information about the latest updates. The book walks you through troubleshooting, syncing mobile devices, integrating Windows, and more, so you can take advantage of everything Macs have to offer. Whether you're a new user, a recent convert, or you just want to get the most out of your Mac, this book puts all the information you need in one place. Discover what makes Macs superior computing machines. Learn the basics, from mastering the Dock and

  1. Windows for Intel Macs

    CERN Document Server

    Ogasawara, Todd

    2008-01-01

    Even the most devoted Mac OS X user may need to use Windows XP, or may just be curious about XP and its applications. This Short Cut is a concise guide for OS X users who need to quickly get comfortable and become productive with Windows XP basics on their Macs. It covers: Security Networking ApplicationsMac users can easily install and use Windows thanks to Boot Camp and Parallels Desktop for Mac. Boot Camp lets an Intel-based Mac install and boot Windows XP on its own hard drive partition. Parallels Desktop for Mac uses virtualization technology to run Windows XP (or other operating systems

  2. A Successful Partnership to Help Reduce Health Disparities at Kaiser Permanente: The Institute for Culturally Competent Care and the Kaiser Permanente School of Anesthesia

    OpenAIRE

    Chong, Nilda; Elisha, Sassoon M; Maglalang, Maria; Koh, Karen

    2006-01-01

    An innovative partnership with the Kaiser Permanente (KP) Institute for Culturally Competent Care (ICCC) has enabled the KP School of Anesthesia (KPSA) to become one of the first nurse anesthetist programs in the western United States to incorporate a formal cultural competence curriculum into its educational program. Housed administratively in the California State University system since 1981, KPSA is a fully accredited, 24-month program that educates registered nurses to become certified re...

  3. Caring about medullary anesthesia in Saimiri sciureus: the conus medullaris topography

    Directory of Open Access Journals (Sweden)

    Ana R. Lima

    2011-12-01

    Full Text Available Saimiri sciureus is a New World non-human primate (NHP that inhabits Brazilian rain forests. Surgical interventions in wild NHPs can be considered common both for experimental studies procedures and corrective procedures for endangered species. Among various anesthetic procedures, the epidural anesthesia or blockades, depending on the surgical procedure, might be considered elective for wild monkeys, mostly based on its safeness, efficiency and non-time consuming characteristics. However its safeness would be limiting because of the spinal cord arrangement. Notwithstanding the available former studies on New World NHP anatomy, the description of the medullar cone of Saimiri sciureus is still scarce. Therefore, we believe that the better understanding the medullar cone of Saimiri sciureus would contribute to improve the applicability of epidural procedures in the species. Vertebrae architecture of Saimiri sciureus was composed by 9 lumbar, 3 sacral and 18 coccygeal vertebrae, and the medullar cone measured about 3.3 cm. We can conclude that the conus medullaris in Saimiri sciureus is situated more caudally in comparison to other species.Saimiri sciureus é um primata não humano do novo mundo (NHP que habita as florestas úmidas brasileiras. Intervenções cirúrgicas em NHP selvagens podem ser consideradas comuns em estudos experimentais ou procedimentos corretivos para espécies em perigo. Entre os vários procedimentos anestésicos, a anestesia ou bloqueio epidural depende do procedimento cirúrgico a ser realizado, podendo ser considerada eletiva para macacos selvagens baseada na segurança, eficiência e pouco tempo consumido, entretanto sua segurança pode estar limitada devido ao arranjo da medula espinhal. Apesar de existirem estudos anatômicos disponíveis de NHP a descrição do cone medular do Saimiri sciureus permanece escassa. Portanto, nós acreditamos que o melhor entendimento a respeito do cone medular do Saimiri sciureus pode

  4. [A computer-controlled closed circle system for ventilation during anesthesia and intensive care and its possibilities for patient monitoring].

    Science.gov (United States)

    Verkaaik, A P; Rubreht, J; van Dijk, G; Westerkamp, B; Erdmann, W

    1991-01-01

    A computer feed back controlled anaesthesia- and intensive care ventilator has been developed with on-line and separate lung function measurement. The system design is built on the principle of a totally closed circuit (closed rebreathing respirometer) and an inspiratory "high flow", the gas being rotated through the closed circuit unidirectionally by a blower with 70 l/min. Ventilation is performed by metal membranes freely movable in membrane chambers with an internal part included into the closed circuit and an external part connected to pressurized air controlling inspiratory valves expiratory valves. The electronic valves are software controlled by the computer to exactly perform the desired preset ventilatory mode. Membrane movement are on-line measured capacitively and transformed into respective flow and volume values, whereby the compressibility of the system gas (on-line pressure recording) is taken into account. Volatile anaesthetic gases are feed back controlled to preset end expiratory values (MAC-controlled anaesthesia), circuit volume is maintained by N20-addition and oxygen is added to maintain the desired present inspiratory concentration measured with paramagnetic oxygen sensors. Ergonometric aspects led to the triangular from of the new anaesthesia and intensive care ventilator with the controlling service screen turnable to all three sides of the ventilator (high flexibility of the user) and all necessary equipment and material included into the "Anaesthesia workstation". All measured and present parameters are continuously displayed on the service (computer) screen and entered into the computer-memory in minute cycles with a memory capacity of 75 h anaesthesia. At any desired moment the memorized values can be transferred to IBM-compatible disc systems for storage or into the respective data management systems, thus at the end of anaesthesia, at the end of the working day or at the end of the week. PMID:1888427

  5. Comparative study between dexmedetomidine/nalbuphine and midazolam/nalbuphine in monitored anesthesia care during ear surgery

    Directory of Open Access Journals (Sweden)

    Mahmoud Hassan Mohamed

    2014-01-01

    Conclusion: We concluded that the combination of dexmedetomidine/nalbuphine is a better alternative to midazolam/nalbuphine in MAC since it provides analgesia, amnesia and sedation with better intraoperative and postoperative patient satisfaction with better surgical field exposure.

  6. Regional anesthesia for management of acute pain in the intensive care unit

    OpenAIRE

    Pinto, Mario; Dagal, Armagan; O’Donnell, Brendan; Stogicza, Agnes; Chiu, Sheila; Edwards, William Thomas

    2015-01-01

    Pain is a major problem for Intensive Care Unit (ICU) patients. Despite numerous improvements it is estimated that as many as 70% of the patients experience moderate-to-severe postoperative pain during their stay in the ICU. Effective pain management means not only decreasing pain intensity, but also reducing the opioids’ side effects. Minimizing nausea, vomiting, urinary retention, and sedation may indeed facilitate patient recovery and it is likely to shorten the ICU and hospital stay. Adeq...

  7. Anesthesia and Intensive care implications for pituitary surgery: Recent trends and advancements

    OpenAIRE

    Sukhminder Jit Singh Bajwa; Sukhwinder Kaur Bajwa

    2011-01-01

    The advancements in neuro-endocrine surgical interventions have been well supported by similar advancements in anesthesiology and intensive care. Surgery of the pituitary tumor poses unique challenges to the anesthesiologists and the intensivists as it involves the principles and practices of both endocrine and neurosurgical management. A multidisciplinary approach involving the endocrine surgeon, neurosurgeon, anesthesiologist, endocrinologist and intensivist is mandatory for a successful su...

  8. Mac OS X Forensics

    Science.gov (United States)

    Craiger, Philip; Burke, Paul

    This paper describes procedures for conducting forensic examinations of Apple Macs running Mac OS X. The target disk mode is used to create a forensic duplicate of a Mac hard drive and preview it. Procedures are discussed for recovering evidence from allocated space, unallocated space, slack space and virtual memory. Furthermore, procedures are described for recovering trace evidence from Mac OS X default email, web browser and instant messaging applications, as well as evidence pertaining to commands executed from a terminal.

  9. Enterprise Mac administrators guide

    CERN Document Server

    Smith, William

    2015-01-01

    IT departments everywhere will be integrating Macs and Mac OS X into their IT infrastructure and this book will tell them how to do it. It will serve as an authoritative, useful and frequently referenced book on Mac OS X administration.

  10. Spinal and epidural anesthesia

    Science.gov (United States)

    Intraspinal anesthesia; Subarachnoid anesthesia; Epidural; Peridural anesthesia ... Spinal and epidural anesthesia have fewer side effects and risks than general anesthesia (asleep and pain-free). Patients usually recover their senses ...

  11. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital

    OpenAIRE

    Asma Abdus Salam; Gauhar Afshan

    2016-01-01

    Background and Aims: Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by eld...

  12. Enterprise Mac Administrator's Guide

    CERN Document Server

    Edge, Charles; Hunter, Beau

    2009-01-01

    Charles Edge, Zack Smith, and Beau Hunter provide detailed explanations of the technology required for large-scale Mac OS X deployments and show you how to integrate it with other operating systems and applications. Enterprise Mac Administrator's Guide addresses the growing size and spread of Mac OS X deployments in corporations and institutions worldwide. In some cases, this is due to the growth of traditional Mac environments, but for the most part it has to do with "switcher" campaigns, where Windows and/or Linux environments are migrating to Mac OS X. However, there is a steep cu

  13. Variable time-delay estimation for anesthesia control during intensive care.

    Science.gov (United States)

    Ionescu, Clara M; Hodrea, Ramona; De Keyser, Robin

    2011-02-01

    The presence of artifacts plays a crucial role in automatic sedation systems and may introduce variable time delays (TDs) in the closed-loop-control structures. This paper presents a successful procedure to estimate the varying TD of the bispectral index (BIS) monitor used in closed-loop control during intensive care. The TD estimation (TDE) is based on the cross-correlation analysis technique and the method is validated with real measured signals of propofol and BIS. Extended prediction self-adaptive control is used in combination with a Smith predictor to reduce the computational burden imposed by the variable TD. The conclusion is that an online TDE of the BIS monitor improves the performance of the closed-loop system for reference tracking, disturbance rejection, and overall stability. PMID:20959260

  14. Regional anesthesia for management of acute pain in the intensive care unit.

    Science.gov (United States)

    De Pinto, Mario; Dagal, Armagan; O'Donnell, Brendan; Stogicza, Agnes; Chiu, Sheila; Edwards, William Thomas

    2015-01-01

    Pain is a major problem for Intensive Care Unit (ICU) patients. Despite numerous improvements it is estimated that as many as 70% of the patients experience moderate-to-severe postoperative pain during their stay in the ICU. Effective pain management means not only decreasing pain intensity, but also reducing the opioids' side effects. Minimizing nausea, vomiting, urinary retention, and sedation may indeed facilitate patient recovery and it is likely to shorten the ICU and hospital stay. Adequate postoperative and post-trauma pain management is also crucial for the achievement of effective rehabilitation. Furthermore, recent studies suggest that effective acute pain management may be helpful in reducing the development of chronic pain. When used appropriately, and in combination with other treatment modalities, regional analgesia techniques (neuraxial and peripheral nerve blocks) have the potential to reduce or eliminate the physiological stress response to surgery and trauma, decreasing the possibility of surgical complications and improving the outcomes. Also they may reduce the total amount of opioid analgesics necessary to achieve adequate pain control and the development of potentially dangerous side effects. PMID:26557482

  15. Anesthesia and Intensive care implications for pituitary surgery: Recent trends and advancements

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2011-01-01

    Full Text Available The advancements in neuro-endocrine surgical interventions have been well supported by similar advancements in anesthesiology and intensive care. Surgery of the pituitary tumor poses unique challenges to the anesthesiologists and the intensivists as it involves the principles and practices of both endocrine and neurosurgical management. A multidisciplinary approach involving the endocrine surgeon, neurosurgeon, anesthesiologist, endocrinologist and intensivist is mandatory for a successful surgical outcome. The focus of pre-anesthetic checkup is mainly directed at the endocrinological manifestations of pituitary hypo or hyper-secretion as it secretes a variety of essential hormones, and also any pathological state that can cause imbalance of pituitary secretions. The pathophysiological aspects associated with pituitary tumors mandate a thorough airway, cardiovascular, neurologic and endocrinological assessment. A meticulous preoperative preparation and definite plans for the intra-operative period are the important clinical components of the anesthetic strategy. Various anesthetic modalities and drugs can be useful to provide a smooth intra-operative period by countering any complication and thus providing an uneventful recovery period.

  16. Seniors and Anesthesia

    Science.gov (United States)

    ... Media Anesthesia 101 Patient Safety Stories Resources About Home » Patients » Preparing For Surgery » Seniors and Anesthesia Share this Page Preparing For Surgery Effects of Anesthesia Children and Anesthesia Pregnancy, Childbirth and Anesthesia Seniors and Anesthesia Surgery Risks Anesthesia ...

  17. Anesthesia Basics

    Science.gov (United States)

    ... giving you anesthesia. CRNAs may work under the supervision of a anesthesiologist or on their own — it ... lot over the years, thanks to advances in technology and the extensive training anesthesiologists receive. The more ...

  18. Anesthesia for radiologic procedures

    International Nuclear Information System (INIS)

    Anesthetic techniques for neurodiagnostic studies and radiation therapy have been recently reviewed, but anesthetic involvement in thoracic and abdominal radiology has received little attention. Patient reactions to radiologic contrast media may be of concern to the anesthesiologist, who is often responsible for injecting these agents during diagnostic procedures, and thus is included in this discussion. Finally, the difficulties of administering anesthesia for magnetic resonance imaging (MRI) scans are outlined, in an effort to help anesthesiologist to anticipate problems with this new technologic development. Although there are very few indications for the use of general anesthesia for diagnostic radiologic studies in adults, most procedures performed with children, the mentally retarded, or the combative adult require either heavy sedation or general anesthesia. In selecting an anesthetic technique for a specific procedure, both the patient's disease process and the requirements of the radiologist must be carefully balanced

  19. General anesthesia for dental care management of a patient with epidermolysis bullosa: 24-month follow-up.

    Science.gov (United States)

    Mello, Bianca Zeponi Fernandes; Neto, Natalino Lourenço; Kobayashi, Tatiana Yuriko; Mello, Marina Barbosa Almeida; Ambrosio, Eloá Cristina Passucci; Yaedú, Renato Yassutaka Faria; Machado, Maria Aparecida Andrade Moreira; Oliveira, Thais Marchini

    2016-07-01

    Epidermolysis bullosa comprises a group of uncommon skin-related diseases, characterized by the formation of blisters on mucocutaneous regions occurring spontaneously, following a trauma, exposure to heat, or as a result of minimal mechanical trauma. The dental treatment of the patient with epidermolysis bullosa raises many questions and discussions, due to the difficulty of carrying out the procedures. This report aimed to detail the clinical considerations of the treatment under general anesthesia of a patient with epidermolysis bullosa. The extraction of all deciduous teeth under general anesthesia was recommended based on the clinical and radiographic examinations. At 24-month follow-up, the patient had great improvement in oral hygiene without new caries lesions. The patient has been followed-up at every month for caries lesion prevention and permanent tooth development. The treatment under general anesthesia provided the ideal safe conditions and was beneficial for the patient. PMID:26936632

  20. Mac at Work

    CERN Document Server

    Sparks, David

    2011-01-01

    Bridge the gap between using a Mac at home and at the office. Now that you love your Mac at home, you want to use one at the office without missing a beat of productivity or professionalism. This unique guide shows you how.  You'll find best Mac business practices for handling word processing, spreadsheet and presentation creation, task and project management, and graphics. The book also explores topics such as hardware maintenance, how to synchronize with multiple computers, data backup, and communication with Windows networks.: Covers the nuts and bolts of using a Mac at work, including sync

  1. Macs portable genius

    CERN Document Server

    McFedries, Paul

    2010-01-01

    Facts, tips, and secrets for using the powerful-but less obvious-features of a Mac Packed with tricks, tools, and shortcuts that you may not discover by simply working with a program or software on your Mac, Macs Portable Genius, 2nd Edition reveals smart and innovative ways to execute various tasks that can save you time and hassle. Its handy smaller trim size makes it easy for you to find essential information, coupled with savvy advice on everything from simple tasks like getting started to intermediate information and hip tips that cover how to use Macs and related hardware. Reveals fac

  2. Remifentanil for the insertion and removal of long-term central venous access during monitored anesthesia care.

    LENUS (Irish Health Repository)

    Burlacu, Crina L

    2012-02-01

    STUDY OBJECTIVE: To determine the analgesic efficacy of three different rates of remifentanil infusion in patients undergoing insertion or removal of long-term central venous access devices during monitored anesthesia care and local anesthetic field infiltration. DESIGN: Double-blinded, randomized, controlled study. SETTING: Operating theatre of an University hospital. PATIENTS: 44 unpremedicated, ASA physical status 1 and 2 patients, aged 18-65 years, undergoing insertion or removal of a Port-a-Cath or Hickman catheter. INTERVENTIONS: Patients sedated with a propofol target-controlled infusion were randomly allocated to three groups: Group R25 (n = 14), Group R50 (n = 15), and Group R75 (n = 15), to receive remifentanil 0.025, 0.05, and 0.075 mug\\/kg\\/min, respectively. Rescue remifentanil 0.5 mug\\/kg was administered for pain scores > 3. The remifentanil infusion rate was maintained constant unless respiratory and\\/or cardiovascular unwanted events occurred, whereupon the rate was adjusted in 0.01 mug\\/kg\\/min decrements as necessary. MEASUREMENTS: Pain scores (primary outcome), sedation, and movement scores (secondary outcomes) were assessed during local anesthetic infiltration of the anterior chest wall and 5 other procedural steps. MAIN RESULTS: All infusion rates had equal analgesic efficacy, as shown by comparable pain scores, number of rescue boluses, and number of patients requiring rescue analgesia. Excessive sedation was associated with the highest remifentanil rate such that Group R75 patients were significantly more sedated than Groups R25 or R50 at selective procedural steps (P < 0.05). More Group R75 patients (6\\/15) required remifentanil rate reduction than did patients from Group R50 (1\\/15) or Group R25 (0\\/14), P < 0.01, most commonly because of respiratory depression. CONCLUSIONS: For the insertion or removal of long-term central venous access devices, all three remifentanil infusion rates proved to be equally analgesic

  3. Knowledge about Anesthesia and Perception about Anesthesiologists among Patients at a Rural Tertiary Care Hospital: A Cross Sectional Survey

    Directory of Open Access Journals (Sweden)

    Birva N Khara

    2013-08-01

    Conclusion: The available data suggest that specialty of anesthesia has not done all that it can to educate the patients in particular and the public at large about the role of anesthesiologist. [Natl J Med Res 2013; 3(4.000: 371-373

  4. Enterprise Mac Security Mac OS X Snow Leopard Security

    CERN Document Server

    Edge, Stephen Charles; Hunter, Beau; Sullivan, Gene; LeBlanc, Dee-Ann

    2010-01-01

    A common misconception in the Mac community is that Mac's operating system is more secure than others. While this might be true in certain cases, security on the Mac is still a crucial issue. When sharing is enabled or remote control applications are installed, Mac OS X faces a variety of security threats. Enterprise Mac Security: Mac OS X Snow Leopard is a definitive, expert-driven update of the popular, slash-dotted first edition and was written in part as a companion to the SANS Institute course for Mac OS X. It contains detailed Mac OS X security information, and walkthroughs on securing s

  5. Introduction to MAC CRM training

    Science.gov (United States)

    Brown, Donald D.

    1987-01-01

    The author introduces the Military Airlift Command (MAC) and its mission. A brief history of Cockpit Resource Management (CRM) as it relates to MAC is given. He also states why MAC is currently interested in CRM.

  6. Nurse Anesthetists' Perceptions Regarding Utilization of Anesthesia Support Personnel

    Science.gov (United States)

    Ford, Mary Bryant

    2010-01-01

    Anesthesia support personnel (ASP) provide direct support to health care providers administering anesthesia (Certified Registered Nurse Anesthetists [CRNAs] and anesthesiologists). Because these anesthesia providers are caring for a patient whom they cannot legally or ethically leave unattended, ASP are employed to bring them extra supplies or…

  7. Specialist training in pediatric anesthesia

    DEFF Research Database (Denmark)

    Hansen, Tom G

    2009-01-01

    There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of...... Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved by...

  8. Intestinal circulation during inhalation anesthesia

    International Nuclear Information System (INIS)

    This study was designed to evaluate the influence of inhalational agents on the intestinal circulation in an isolated loop preparation. Sixty dogs were studied, using three intestinal segments from each dog. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mmHg. A mixture of 86Rb and 9-microns spheres labeled with 141Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A very strong and significant correlation was found between rubidium clearance and microsphere entrapment (r = 0.97, P less than 0.0001). Nitrous oxide anesthesia was accompanied by a higher vascular resistance (VR), lower flow (F), rubidium clearance (Cl-Rb), and microspheres entrapment (Cl-Sph) than pentobarbital anesthesia, indicating that the vascular bed in the intestinal segment was constricted and flow (total and nutritive) decreased. Halothane, enflurane, and isoflurane anesthesia were accompanied by a much lower arteriovenous oxygen content difference (AVDO2) and oxygen uptake than pentobarbital or nitrous oxide. Compared with pentobarbital, enflurane anesthesia was not accompanied by marked differences in VR, F, Cl-Rb, and Cl-Sph; halothane at 2 MAC decreased VR and increased F and Cl-Rb while isoflurane increased VR and decreased F. alpha-Adrenoceptor blockade with phentolamine (1 mg . kg-1) abolished isoflurane-induced vasoconstriction, suggesting that the increase in VR was mediated via circulating catecholamines

  9. Enterprise Mac Managed Preferences

    CERN Document Server

    Marczak, Edward

    2010-01-01

    Many systems administrators on the Mac need a way to manage machine configuration after initial setup and deployment. Apple's Managed Preferences system (also known as MCX) is under-documented, often misunderstood, and sometimes outright unknown by sys admins. MCX is usually deployed in conjunction with an OS X server, but it can also be used in Windows environments or where no dedicated server exists at all. Enterprise Mac Managed Preferences is the definitive guide to Apple's Managed Client technology. With this book, you'll get the following: * An example-driven guide to Mac OS X Managed Pr

  10. McGRATH MAC videolaryngoscope versus Macintosh laryngoscope for orotracheal intubation in intensive care patients: the randomised multicentre MACMAN trial study protocol

    OpenAIRE

    Bailly, Arthur; Lascarrou, Jean Baptiste; Le Thuaut, Aurelie; Boisrame-Helms, Julie; Kamel, Toufik; Mercier, Emmanuelle; Ricard, Jean Damien; Lemiale, Virginie; Champigneulle, Benoit; Reignier, Jean

    2015-01-01

    Introduction Critically ill patients with acute respiratory, neurological or cardiovascular failure requiring invasive mechanical ventilation are at high risk of difficult intubation and have organ dysfunctions associated with complications of intubation and anaesthesia such as hypotension and hypoxaemia. The complication rate increases with the number of intubation attempts. Videolaryngoscopy improves elective endotracheal intubation. McGRATH MAC is the lightest videolaryngoscope and the mos...

  11. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital

    Science.gov (United States)

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

    Background and Aims: Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. Material and Methods: A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Results: Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. Conclusion: This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information. PMID:27006550

  12. Combining isoflurane anesthesia with midazolam and butorphanol in rats.

    Science.gov (United States)

    Tsukamoto, Atsushi; Uchida, Kaho; Maesato, Shizuka; Sato, Reiichiro; Kanai, Eiichi; Inomata, Tomo

    2016-07-29

    Representative inhalant anesthetic agent, isoflurane is commonly used during surgery in rats. However, isoflurane mediates relatively strong respiratory depression. In human and veterinary medicine, sedatives and analgesics are co-administered to complement the anesthetic action of inhalant anesthesia. The present study aimed to establish the novel balanced anesthesia that combines midazolam and butorphanol with isoflurane (MBI) in rats. Male Sprague Dawley rats were divided into 2 groups, and administered either isoflurane monoanesthesia or isoflurane with midazolam (2.5 mg/kg, ip) and butorphanol (2.0 mg/kg, ip). The minimum alveolar concentration (MAC) in each group was evaluated. Induction and recovery times were measured in each group. Adverse reactions during induction were also recorded. In each group, vital signs were assessed for 1 h under 1.5×MAC of isoflurane. Instability of vital signs was assessed under each anesthesia by calculating coefficient of variance. Compared with isoflurane monoanesthesia, MBI anesthesia caused 32% MAC reduction (isoflurane monoanesthesia: 1.30 ± 0.09%, MBI 0.87 ± 0.08%, PMBI anesthesia resulted in a relatively stable respiratory rate without decreases in SPO2 during the anesthetic period. In summary, MB premedication is effective for attenuating respiratory depression induced by isoflurane, and achieving smooth induction. This anesthetic protocol serves as a novel option for appropriate anesthesia in rats. PMID:26876437

  13. Society for Ambulatory Anesthesia

    Science.gov (United States)

    ... We Represent Ambulatory and Office-Based Anesthesia The Society for Ambulatory Anesthesia provides educational opportunities, encourages research ... 6620 | E-mail: info@sambahq.org Copyright | 2016 Society for Ambulatory Anesthesia Home | Search | Terms | Privacy Policy | ...

  14. Obesity and Anesthesia

    Science.gov (United States)

    ... Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery Obesity and Anesthesia More than one-third of Americans ... Sleep Apnea, a chronic medical problem common with obesity, can present with serious breathing problems before, during, ...

  15. Macs For Seniors For Dummies

    CERN Document Server

    Chambers, Mark L

    2012-01-01

    You're never too old to fall in love—with your Mac! You took a while, but you are now the proud owner of your first Mac computer. Macs For Seniors For Dummies is just for you. This friendly, accessible guide walks you through choosing a Mac and learning how to use it. You'll find yourself falling head over heels for your Mac in no time. Macs For Seniors For Dummies introduces you to all the basics that you need to know: turning the Mac on and getting connected; using the keyboard and mouse; working with files and folders; navigate around the Mac desktop and OS X Lion; setting up an Inter

  16. MAC calorimeters and applications

    International Nuclear Information System (INIS)

    The MAC detector at PEP features a large solid-angle electromagnetic/hadronic calorimeter system, augmented by magnetic charged-particle tracking, muon analysis and scintillator triggering. Its implementation in the context of electron-positron annihilation physics is described, with emphasis on the utilization of calorimetry

  17. Anesthesia and Monitoring in Small Laboratory Mammals Used in Anesthesiology, Respiratory and Critical Care Research: A Systematic Review on the Current Reporting in Top-10 Impact Factor Ranked Journals.

    Directory of Open Access Journals (Sweden)

    Christopher Uhlig

    Full Text Available This study aimed to investigate the quality of reporting of anesthesia and euthanasia in experimental studies in small laboratory mammals published in the top ten impact factor journals.A descriptive systematic review was conducted and data was abstracted from the ten highest ranked journals with respect to impact factor in the categories 'Anesthesiology', 'Critical Care Medicine' and 'Respiratory System' as defined by the 2012 Journal Citation Reports. Inclusion criteria according to PICOS criteria were as follows: 1 population: small laboratory mammals; 2 intervention: any form of anesthesia and/or euthanasia; 3 comparison: not specified; 4 primary outcome: type of anesthesia, anesthetic agents and type of euthanasia; secondary outcome: animal characteristics, monitoring, mechanical ventilation, fluid management, postoperative pain therapy, animal care approval, sample size calculation and performed interventions; 5 study: experimental studies. Anesthesia, euthanasia, and monitoring were analyzed per performed intervention in each article.The search yielded 845 articles with 1,041 interventions of interest. Throughout the manuscripts we found poor quality and frequency of reporting with respect to completeness of data on animal characteristics as well as euthanasia, while anesthesia (732/1041, 70.3% and interventions without survival (970/1041, 93.2% per se were frequently reported. Premedication and neuromuscular blocking agents were reported in 169/732 (23.1% and 38/732 (5.2% interventions, respectively. Frequency of reporting of analgesia during (117/610, 19.1% and after painful procedures (38/364, 10.4% was low. Euthanasia practice was reported as anesthesia (348/501, 69%, transcardial perfusion (37/501, 8%, carbon dioxide (26/501, 6%, decapitation (22/501, 5%, exsanguination (23/501, 5%, other (25/501, 5% and not specified (20/501, 4%, respectively.The present systematic review revealed insufficient reporting of anesthesia and euthanasia

  18. Anesthesia for fetoscopic intervention

    Directory of Open Access Journals (Sweden)

    Jamil S Anwari

    2014-01-01

    Full Text Available This is the first case report on anesthesia for fetoscopy performed in Saudi Arabia. Epidural anesthesia was given to the mother in her late second trimester for the fetoscopic intervention. The anesthesia related issues such as physiological and anatomical changes in pregnancy, tocolytic medications and their interactions with anesthesia, anesthetizing/sedating the primary patient are discussed.

  19. iMac pocket genius

    CERN Document Server

    Hart-Davis, Guy

    2010-01-01

    If you want to get the very most out of your iMac, put this savvy Portable Genius guide to work. Want to make the most of the new Magic Mouse and the latest iLife apps? Set up a wireless network using your iMac's AirPort card? Watch television on your iMac, or show iMac videos and movies on your television? You'll find cool and useful Genius tips, full-color screenshots, and pages of easy-to-access shortcuts and tools that will save you time and let you enjoy your iMac to the max.

  20. Macs For Dummies, Pocket Edition

    CERN Document Server

    Baig, Edward C

    2011-01-01

    The fun and easy way to make the most of your wonderful Mac. Simply Mac-nificent — all the cool things your Mac can do! This handy guide helps you figure out the nuts and bolts of your Mac. Navigate the Mac desktop, use the Safari Web browser to surf the Internet, e-mail photos to friends and family, create and print documents, rip audio CDs, and more. The fun begins right here!. Open the book and find: How to set up and configure your Mac; Tips for getting around on the Mac desktop; Steps for setting up an e-mail account and browsing the Internet; Details about the free programs that come wit

  1. iMac portable genius

    CERN Document Server

    Hart-Davis, Guy

    2010-01-01

    The most up-to-date coverage on the latest iMac advice, tools, and shortcuts Cool and useful tips, full-color screenshots, and savvy advice show you how to get the most out of your iMac. Fully updated to cover the iMac's latest features and capabilities, this guide is packed with indispensible information on iLife '09 and Mac OS X Snow Leopard, and shows you how to customize your iMac in a way that it will work best for you.Explores all the bells and whistles of the iMac, including the new Magic Mouse, iLife apps such as iPhoto and iMovie, and Mac OS X Snow LeopardShows yo

  2. Mac OS X

    OpenAIRE

    Ma, I

    2001-01-01

    Introduction: Apple Computer has just released its new operating system for the Macintosh Computer OSX, which has been called "the next generation" of computer operating systems. This session will demonstrate the features of the new operating system and compare it to previous operating systems. Details: Mac OS X is a super-modern operating system that combines the power and stability of UNIX with the legendary simplicity and elegance of the Macintosh. Key Features Aqua...

  3. Comparison of acute physiology and chronic health evaluation II and Glasgow Coma Score in predicting the outcomes of Post Anesthesia Care Unit′s patients

    Directory of Open Access Journals (Sweden)

    Mohammad Hosseini

    2015-01-01

    Full Text Available Context: Acute physiology and chronic health evaluation II (APACHE II is one of the most general classification systems of disease severity in Intensive Care Units and Glasgow Coma Score (GCS is one of the most specific ones. Aims: The aim of the current study was to assess APACHE II and GCS ability in predicting the outcomes (survivors, non-survivors in the Post Anesthesia Care Unit′s (PACU. Settings and Design: This was an observational and prospective study of 150 consecutive patients admitted in the PACU during 6-month period. Materials and Methods: Demographic information recorded on a checklist, also information about severity of disease calculated based on APACHE II scoring system in the first admission 24 h and GCS scale. Statistical Analysis Used: Logistic regression, Hosmer-Lemeshow test and receiver operator characteristic (ROC curves were used in statistical analysis (95% confidence interval. Results: Data analysis showed a significant statistical difference between outcomes and both APACHE II and Glasgow Coma Score (GCS (P < 0.0001. The ROC-curve analysis suggested that the predictive ability of GCS is slightly better than APACHE II in this study. For GCS the area under the ROC curve was 86.1% (standard error [SE]: 3.8%, and for APACHE II it was 85.7% (SE: 3.5%, also the Hosmer-Lemeshow statistic revealed better calibration for GCS (χ2 = 5.177, P = 0.521, than APACHE II (χ2 = 10.203, P = 0.251. Conclusions: The survivors had significantly lower APACHE II and higher GCS compared with non-survivors, also GCS showed more predictive accuracy than APACHE II in prognosticating the outcomes in PACU.

  4. iMac for dummies

    CERN Document Server

    Chambers, Mark L

    2014-01-01

    Do it all with your iMac and this bestselling For Dummies guide! You're still a little giddy from finally scoring your new iMac, and you can't wait to get started. Even if you're already in love with your iMac, it helps to have a little guidance to really get the most out of this ultimate all-in-one computer. This updated edition of iMac For Dummies is the ideal way to learn the iMac fundamentals from setting up and personalizing your machine to importing files, making FaceTime video calls, surfing the web, using your favorite programs and apps, and everything in between. Trusted Mac guru Mark

  5. Hand Surgery: Anesthesia

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon Hand Surgery Anesthesia Email to a friend * required fields From * To * ... in to name and customize your collection. DESCRIPTION Anesthesia is a way to control pain during a ...

  6. Topical anesthesia in phacoemulsification

    Directory of Open Access Journals (Sweden)

    Saad Waheeb

    2010-01-01

    Conclusion : Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon.

  7. iMac portable genius

    CERN Document Server

    Binder, Kate

    2008-01-01

    Cool and useful tips, full-color screenshots, and savvy advice show you how to get the most out of your iMac. You'll discover exactly what the Apple remote is capable of, how to set up your iMac so that it's customized for multiple users, and all there is to know about Mac OS X's built-in organizational tools. This indispensable guide ramps up the pace and offers you easy-to-access shortcuts so you can start enjoying your iMac to the max.

  8. Learn Excel 2011 for Mac

    CERN Document Server

    Hart-Davis, Guy

    2011-01-01

    Microsoft Excel 2011 for Mac OS X is a powerful application, but many of its most impressive features can be difficult to find. Learn Excel 2011 for Mac by Guy Hart-Davis is a practical, hands-on approach to learning all of the details of Excel 2011 in order to get work done efficiently on Mac OS X. From using formulas and functions to creating databases, from analyzing data to automating tasks, you'll learn everything you need to know to put this powerful application to use for a variety of tasks. What you'll learn * The secrets of the Excel for Mac interface! * How to create effective workbo

  9. The fourth suture in MACS facelifting – adressing the neck

    Directory of Open Access Journals (Sweden)

    Kaye, Kai O.

    2014-12-01

    Full Text Available Objective: The MACS facelift alone shows poor results on the medial neck in cases of pronounced, rigid platysmabands (McKinney III–IV°. The original MACS (“Minimal Access Cranial Suspension” facelift delirs excellent results on the midface and leads to sustainably improved outcome on the neck by adding a fourth suture on the platysma. McKinney type I–II platysmabands can be treated only by lateral approach of the ‘fourth suture’, type III–IV should be treated with closed platysma myotomy before.Methods: Between October 2007 and November 2013 a number of 219 patients were treated with the MACS facelift technique accomplished by a fourth suture on the platysma and liposuction or optional lipectomy on the neck. On 47 patients closed transcutaneous platysma myotomy was performed.Results: Surgery time lasted on average 2.5 hours and was performed under sedation with local anesthesia in 85%. Recovery time ranged between 14 to 16 days until the patients were back to work. Due to their health status 54% of our patients had an inpatient arrangement for one night and 46% an outpatient arrangement.Conclusion: The modification of the MACS lift with the ‘fourth suture’ on the platysma keeps the benefits of the original technique but improves the aesthetic outcome on the neck.

  10. iMac for dummies

    CERN Document Server

    Chambers, Mark L

    2012-01-01

    The bestselling guide to the ultimate all-in-one computer—now updated and revised throughout! If you're looking for speed, performance, and power, the iMac is the ultimate all-in-one computer. From its superior performance, powerful operating system, and amazing applications, the iMac is one awesome machine, and the fun, friendly, and approachable style of iMac For Dummies is an ideal way to get started with the basics. You'll learn the fundamentals of the iMac including setting up and customizing your iMac and the software that comes with it, importing files from your old computer, send

  11. Macs for seniors for dummies

    CERN Document Server

    Chambers, Mark L

    2009-01-01

    Over 50 and thinking about getting your first computer? A user-friendly Mac is a great choice, and Macs For Seniors For Dummies walks you through choosing one and learning to use it. You won't even need your grandchildren to help! Macs For Seniors For Dummies introduces you to all the basic things you may not have encountered before-how to use the keyboard and mouse, work with files and folders, navigate around the Mac OS X desktop, set up an Internet connection, and much more. You'll learn to:Choose the Mac that's right for you, set it up, run programs and manage files, and hook up a printerU

  12. Windows Mac-tietokoneilla

    OpenAIRE

    Alhainen, Joona

    2015-01-01

    Tämän opinnäytetyön tarkoituksena oli tutkia eri tapoja, joilla Windows-käyttöjärjestelmää ja Windows-ohjelmia voidaan käyttää Mac-tietokoneilla ja selvittää millaiseen käyttöön eri tavat sopivat parhaiten. Työssä tehdään Windowsin asennukset eri tavoilla ja vertaillaan näiden tapojen vaikutusta tietokoneen suorituskykyyn. Windows asennetaan OS X:n Boot Camp -apuohjelman avulla, jolloin tietokoneen voi käynnistää jompaankumpaan käyttöjärjestelmään sekä virtuaalikoneeseen, jolloin Windowsia...

  13. Hands-Off Time for Endotracheal Intubation during CPR Is Not Altered by the Use of the C-MAC Video-Laryngoscope Compared to Conventional Direct Laryngoscopy. A Randomized Crossover Manikin Study.

    Directory of Open Access Journals (Sweden)

    Philipp Schuerner

    Full Text Available Sufficient ventilation and oxygenation through proper airway management is essential in patients undergoing cardio-pulmonary resuscitation (CPR. Although widely discussed, securing the airway using an endotracheal tube is considered the standard of care. Endotracheal intubation may be challenging and causes prolonged interruption of chest compressions. Videolaryngoscopes have been introduced to better visualize the vocal cords and accelerate intubation, which makes endotracheal intubation much safer and may contribute to intubation success. Therefore, we aimed to compare hands-off time and intubation success of direct laryngoscopy with videolaryngoscopy (C-MAC, Karl Storz, Tuttlingen, Germany in a randomized, cross-over manikin study.Twenty-six anesthesia residents and twelve anesthesia consultants of the University Hospital Zurich were recruited through a voluntary enrolment. All participants performed endotracheal intubation using direct laryngoscopy and C-MAC in a random order during ongoing chest compressions. Participants were strictly advised to stop chest compression only if necessary.The median hands-off time was 1.9 seconds in direct laryngoscopy, compared to 3 seconds in the C-MAC group. In direct laryngoscopy 39 intubation attempts were recorded, resulting in an overall first intubation attempt success rate of 97%, compared to 38 intubation attempts and 100% overall first intubation attempt success rate in the C-MAC group.As a conclusion, the results of our manikin-study demonstrate that video laryngoscopes might not be beneficial compared to conventional, direct laryngoscopy in easily accessible airways under CPR conditions and in experienced hands. The benefits of video laryngoscopes are of course more distinct in overcoming difficult airways, as it converts a potential "blind intubation" into an intubation under visual control.

  14. Gotcha! Macs lose their innocence

    CERN Multimedia

    Computer Security Team

    2012-01-01

    Still believe your Mac is secure because Microsoft PCs fall prey to viruses and worms but Macs don’t? Time to wake up! This year has seen the first major compromise of Macs worldwide*. How is yours doing?   The “Flashback” Trojan is affecting Apple’s own variant of Java and compromises Macs via so-called drive-by infections, i.e. when you visit an appropriately prepared (infected!) website - and this might not necessarily be a site with questionable contents, but could well be a popular, reputable one. Security Companies worldwide have been monitoring this particular Trojan for a while and have estimated that more than half a million Macs were compromised. Connected to a few central command and control servers, the compromised Macs were then supporting the malicious activity of the bad guys! Fortunately, the security companies have now been able to take over those command and control servers and stop their destructive drive. So, Mac users, face the f...

  15. Java and Mac OS X

    CERN Document Server

    Davis, T Gene

    2010-01-01

    Learn the guidelines of integrating Java with native Mac OS X applications with this Devloper Reference book. Java is used to create nearly every type of application that exists and is one of the most required skills of employers seeking computer programmers. Java code and its libraries can be integrated with Mac OS X features, and this book shows you how to do just that. You'll learn to write Java programs on OS X and you'll even discover how to integrate them with the Cocoa APIs.: Shows how Java programs can be integrated with any Mac OS X feature, such as NSView widgets or screen savers; Re

  16. Psychological aspects of pediatric anesthesia

    Directory of Open Access Journals (Sweden)

    Drašković Biljana

    2015-01-01

    Full Text Available Surgery and anesthesia cause a significant emotional stress in both parents and children. Since the consequences of this stress develop immediately after surgery and can last even when the hospital treatment is over, the role of the anesthesiologist is to ensure psychological as well as physiological well-being of the patient. In order to reduce emotional stress induced by anesthesia and operation, the anesthesiologist has to understand certain developmental phases that children go through and to identify situations which a child could potentially see as a danger or a threat. This can usually be achieved by careful preoperative assessment and by administering preoperative sedation. During the preoperative visit to the patient, the anesthesiologist can evaluate the levels of anxiety of both parents and children as well as assess the child’s medical condition.

  17. Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

    Science.gov (United States)

    Vinsonneau, Christophe; Allain-Launay, Emma; Blayau, Clarisse; Darmon, Michael; Ducheyron, Damien; Gaillot, Theophile; Honore, Patrick M; Javouhey, Etienne; Krummel, Thierry; Lahoche, Annie; Letacon, Serge; Legrand, Matthieu; Monchi, Mehran; Ridel, Christophe; Robert, René; Schortgen, Frederique; Souweine, Bertrand; Vaillant, Patrick; Velly, Lionel; Osman, David; Van Vong, Ly

    2015-12-01

    Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice. PMID:26714808

  18. MacBook portable genius

    CERN Document Server

    Miser, Brad

    2008-01-01

    The Genius is in. You don't have to be a genius to use a MacBook. But if you want to get the very most out of yours, put this savvy Portable Genius guide to work. Want to connect your MacBook to other Macs? Use Expose to its fullest potential? Troubleshoot? You'll find cool and useful Genius tips, insider secrets, full-color screenshots, and pages of easy-to-access shortcuts and tools that will save you loads of time and make your MacBook IQ soar. Portable GENIUS Fun, hip, and straightforward, the new Portable Genius series gives forward-thinking Apple users useful informat

  19. Mac Programming for Absolute Beginners

    CERN Document Server

    Wang, Wallace

    2011-01-01

    Want to learn how to program on your Mac? Not sure where to begin? Best-selling author Wallace Wang will explain how to get started with Cocoa, Objective-C, and Xcode. Whether you are an experienced Windows coder moving to the Mac, or you are completely new to programming, you'll see how the basic design of a Mac OS X program works, how Objective-C differs from other languages you may have used, and how to use the Xcode development environment. Most importantly, you'll learn how to use elements of the Cocoa framework to create windows, store data, and respond to users in your own Mac programs.

  20. Apple MacBook Air

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    当乔布斯手持MacBook Air,放言“there is somthing in air”时,苹果教徒们的信仰再一次得到了“升华”。其实再为MacBook Air来写这样一段文字,多少显得有些多余。

  1. Switching to a Mac For Dummies

    CERN Document Server

    Reinhold, Arnold

    2011-01-01

    Learn how to make the switch from PC to Mac a completely smooth transition The number of Mac users continues to increase significantly each year. If you are one of those people and are eager but also anxious about making the switch, then fear not! This friendly guide skips the jargon to deliver you an easy-to-read, understandable introduction to the Macintosh computer. Computer guru Arnold Reinhold walks you through the Mac OS, user interface, and icons. You'll learn how to set up your Mac, move your files from your PC to your Mac, switch applications, get your Mac online, network your Mac, se

  2. Switching to a Mac portable genius

    CERN Document Server

    McFedries, Paul

    2011-01-01

    Switching from a PC to a Mac is a breeze with this book Anyone considering making the move to Mac from the Windows world will find this book smoothes the way. While Macs are famous for ease of use, there are fundamental differences in Mac and PC ways of thinking, plus there?s the hassle of moving files, calendars, and other essential data from one platform to another. This guide lays out all the information, explains basic Mac procedures for the newcomer, offers great tips on data-sharing (including running Windows applications on a Mac), and provides everything the new Mac user needs to move

  3. Fiverr MacGyver

    Science.gov (United States)

    Hut, Rolf; van de Giesen, Nick; Larson, Martha

    2014-05-01

    Crowdsourcing has become popular over the past years, also for scientific endeavors. There are many Citizen Science projects and crowdfunding platforms, such as Kickstarter, that are make helpful contributions to moving environmental science forward. An interesting underused source of useful crowd-derived contributions to research is the website Fiverr.com. On this platform, thousands of people, acting as small-scale freelance contractors, offer their skills in the form of services. The platform offers a chance for people to take a hobby, skill, or pastime and make it something more by reaching out to a wider audience and by receiving a payment in return for services. As is typical of other crowdsourcing platforms, the tasks are small and usually self contained. As the name Fiverr suggests, offers start at US5 to provide a particular service. Services offered range from graphic design, to messages sung or spoken with various styles or accents, to complete apps for Android or iPhone. Skill providers on the platform can accept a range of variation of definition in the tasks, some can be described in general terms, for others it is more appropriate to provide examples. Fiverr provides a central location for those offering skills and those needing services to find each other, it makes it possible to communicate and exchange files, to make payments, and it provides support for resolving disputes. In all cases, it is important to keep expectations aligned with the nature of the platform: quality can and will vary. Ultimately, the critical contribution of Fiverr is not to replace professional services or otherwise save money, but rather to provide access to a large group of people with specialized skills who are able to make a contribution on short notice. In the context of this session, it can be considered a pool of people with MacGyver skills lying in wait of a MacGyyer task to attack. There are many ways in which Fiverr tasks, which are called 'gigs', can be useful in

  4. Anesthesia related Complications in Pediatric GI Endoscopy

    Directory of Open Access Journals (Sweden)

    A Sabzevari

    2014-04-01

    Full Text Available Introduction: Elective upper and lower GI endoscopy is usually performed in children on an outpatient basis with the child under sedation or general anesthesia (GA. The objective of this study was to describe Anesthesia related complications in   children undergoing elective GI endoscopy.   Materials and Methods: The study design was descriptive on 1388 patients undergoing elective GI endoscopy in Sheikh Hospital from 2009 to 2013. All patient received propofol or standard inhalational anesthesia. We examined patients’ demographic data  ,  location of GI endoscopy ,  perioperative vital singe ,  recovery time , respiratory and cardiac complications , post operative nausea and vomiting , agitation , diagnosis and outcome   Results: Pediatric patients aged 2 to 17 years. 29 % of elective GI endoscopy was upper GI endoscopy and 70.3 % was lower GI endoscopy and 0.7 was both of them. 47.7 % of Pediatric patients were female and 52.3 % was male. We haven’t significant or fatal anesthesia related respiratory and cardiac complications (no apnea, no cardiac arrest. 8 patients (0.5% have transient bradicardia in post operative care Unit. 83 patients (5.9% have post operative nausea and vomiting controlled by medication.  6 patients (0.4% have post operative agitation controlled by medication.   Conclusions: General anesthesia and deep sedation in children undergoing elective GI endoscopy haven’t significant or fatal anesthesia related complications. We suggest Anesthesia for infants, young children, children with neurologic impairment, and some anxious older children undergoing elective GI endoscopy. Keyword: Anesthesia, Complication, Endoscopy, Pediatric.

  5. Effects of Anesthesia

    Science.gov (United States)

    ... Regional Anesthesia The potential side effects of regional anesthesia (such as an epidural or spinal block, in which an anesthetic is injected in ... days after the procedure if some of the spinal fluid leaks out. Minor back ... was injected. Serious but rare complications include: Pneumothorax – ...

  6. Neonatal anesthesia with limited resources.

    Science.gov (United States)

    Bösenberg, Adrian T

    2014-01-01

    Neonates are the most vulnerable age group in terms of anesthetic risk and perioperative mortality, especially in the developing world. Prematurity, malnutrition, delays in presentation, and sepsis contribute to this risk. Lack of healthcare workers, poorly maintained equipment, limited drug supplies, absence of postoperative intensive care, unreliable water supplies, or electricity are further contributory factors. Trained anesthesiologists with the skills required for pediatric and neonatal anesthesia as well as basic monitoring equipment such as pulse oximetry will go a long way to improve the unacceptably high anesthetic mortality. PMID:24251423

  7. General anesthesia for horses with specific problems

    International Nuclear Information System (INIS)

    We have discussed anesthetic techniques, special considerations, and expected complications involved in anesthetizing horses for abdominal, orthopedic, and head and neck surgery, and myelography and have described expected physiologic dysfunction that may require changes in anesthetic technique or supportive measures. The objective is high-quality patient care and reduction in anesthesia-related morbidity and death

  8. Mac OS X ja tietoturva

    OpenAIRE

    Herranen, Joni

    2011-01-01

    Tämän opinnäytetyön tavoitteena on luoda kattava kokonaiskuva Mac OS X -käyttöjärjestelmän sisäänrakennetuista tietoturvaratkaisuista ja selvittää miten tietoturvaratkaisut toteuttavat tietoturvan kolmea perustavoitetta eli luottamuksellisuutta, eheyttä ja saatavuutta. Työn kohderyhmäksi on valittu edistyneemmät tietokoneenkäyttäjät, joilla ei ole aikaisempaa Mac-kokemusta. Teoriaosuudessa syvennytään aluksi Apple-yhtiöön sekä Mac OS X -järjestelmän teknisiin ominaisuuksiin. Osuuden pääta...

  9. Office 2011 for Mac For Dummies

    CERN Document Server

    LeVitus, Bob

    2011-01-01

    Get started with Office 2011 for Mac and discover the creative possibilitiesThe leading suite of productivity software for the Mac, Microsoft Office helps users complete common business tasks, including word processing, e-mail, presentations, financial analysis, and much more. Office 2011 for Mac For Dummies is the perfect companion for Microsoft Office for Mac users upgrading to the newest version, new computer users, and those who may have switched from the Windows version of Office. Written by one of the most popular gurus in the Mac community, Bob "Dr. Mac" LeVitus, the book explains every

  10. Orthopedic Anesthesia in Haiti

    OpenAIRE

    Osteen, Kristie D.

    2011-01-01

    Healthcare practitioners from around the world responded almost immediately in the aftermath of the 2010 earthquake in Haiti. This article reports on the efforts of an orthopedic trauma team in Haiti and its efforts in providing surgery without general anesthesia.

  11. Comparison of acceptance, preference and efficacy between pressure anesthesia and classical needle infiltration anesthesia for dental restorative procedures in adult patients

    Directory of Open Access Journals (Sweden)

    Chetana Sachin Makade

    2014-01-01

    Full Text Available Introduction: Intraoral local anesthesia is essential for delivering dental care. Needless devices have been developed to provide anesthesia without injections. Little controlled research is available on its use in dental restorative procedures in adult patients. The aims of this study were to compare adult patients acceptability and preference for needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia. Materials and Methods: Twenty non fearful adults with no previous experience of dental anesthesia were studied using split-mouth design. The first procedure was performed with classical needle infiltration anesthesia. The same amount of anesthetic solution was administered using MADA jet needleless device in a second session one week later, during which a second dental restorative procedure was performed. Patients acceptance was assessed using Universal pain assessment tool while effectiveness was recorded using soft tissue anesthesia and pulpal anesthesia. Patients reported their preference for the anesthetic method at the third visit. The data was evaluated using chi square test and student′s t-test. Results: Pressure anesthesia was more accepted and preferred by 70% of the patients than traditional needle anesthesia (20%. Both needle and pressure anesthesia was equally effective for carrying out the dental procedures. Conclusion: Patients experienced significantly less pain and fear (p<0.01 during anesthetic procedure with pressure anesthesia. However, for more invasive procedures needle anesthesia will be more effective.

  12. The Multidimensional Audioconferencing Classification System (MACS).

    Science.gov (United States)

    Cookson, Peter S.; Chang, Yu-bi

    1995-01-01

    Describes the development of the Multidimensional Audioconferencing Classification System (MACS), an instrument for the tabulation, analysis, and interpretation of audioconferencing instructional interactions. MACS draws on three theoretical and empirical streams: (1) systematic small group interaction analysis; (2) systematic classroom…

  13. NEURAXIAL ANESTHESIA and OBESITY

    OpenAIRE

    Şahin, Aynur; Doğru, Hatice Yılmaz

    2013-01-01

    Obesity is one of the serious condition that commonly effects health in modern age. It was reported that obesity was three-fold increased in the last three decades. According to the statement by World Health Organisation in 2005, 700 million people will be estimated obese in 2015. While neuraxial anesthesia is a commonly used technique in the worldwide, the process may have difficulties in obese patients. In this review, the pathophysiological changes and challenges in neuraxial anesthesia ...

  14. [Rapid opiate detoxification under anesthesia (RODA)].

    Science.gov (United States)

    Dubols, N; Hallet, C; Luppens, D; Ansseau, M; Charlier, C

    2013-01-01

    Rapid Opiate Detoxification under Anesthesia (RODA) involves the use of opiate antagonists combined with anesthesia and pharmacotherapy to reduce withdrawal symptoms. The aim of our study was to measure the plasma concentrations of heroin metabolites and methadone during anesthesia and patient stay at the hospital in order to assess the amount of active substances at each protocol step. Plasma concentrations of antagonists were also quantified and compared to the recommended target values. Blood samples were drawn in 10 patients undergoing RODA at different times of the procedure (during anesthesia, in post-anesthesia care unit and in psychiatry unit). The plasma concentrations of heroin metabolites, methadone and antagonists were measured using a previously described method. Heroin active metabolites were no longer detected in the patient blood when helshe left the hospital; by contrast, methadone was still present at significant concentrations 3 days after the beginning of the detoxification procedure. Naltrexone analysis allowed us to adjust doses to insure opiate receptor blockade during acute withdrawal, which is a critical period. PMID:23888580

  15. Cognitive MAC designs for OSA networks

    CERN Document Server

    Derakhshani, Mahsa

    2014-01-01

    This SpringerBrief presents recent advances in the cognitive MAC designs for opportunistic spectrum access (OSA) networks. It covers the basic MAC functionalities and MAC enhancements of IEEE 802.11. Later chapters discuss the existing MAC protocols for OSA and classify them based on characteristic features. The authors provide new research in adaptive carrier sensing-based MAC designs tailored for OSA, which optimize spectrum utilization and ensure a peaceful coexistence of licensed and unlicensed systems. Analytically devised via optimization and game-theoretic approaches, these adaptive M

  16. Take Control of Maintaining Your Mac

    CERN Document Server

    Kissell, Joe

    2009-01-01

    Keep your Mac running smoothly with our easy maintenance program! Regular maintenance is necessary to avoid problems and to ensure your Mac runs at peak performance, but it's hard to know what to do and when to do it. Best-selling author Joe Kissell has now applied his commonsense approach to the task of maintaining your Mac, whether you use Tiger or Leopard! Learn how to start on the right foot; what you should do daily, weekly, monthly, and yearly; and how to prepare for Mac OS X updates. Joe even explains how to monitor your Mac's health and debunks common panaceas. Read this book to lea

  17. Switching to a Mac For Dummies

    CERN Document Server

    Reinhold, Arnold

    2007-01-01

    Thinking of making the switch from your PC to a Mac? Congratulations! You're in for a great, virus-free ride. And Switching to Mac For Dummies makes it smoother than you ever imagined. From buying the Mac that's right for you to transferring your files to breaking your old Windows habits and learning to do things the (much easier) Mac way, it makes the whole process practically effortless. Whether you've been using Windows XP, Vista, or even Linux, you'll find simple, straightforward ways to make your transition go smoothly. That will leave you plenty of time to get familiar with Mac'

  18. Switching to the Mac The Missing Manual

    CERN Document Server

    Pogue, David

    2010-01-01

    Is Windows giving you pause? Ready to make the leap to the Mac instead? There has never been a better time to switch from Windows to Mac, and this incomparable guide will help you make a smooth transition. New York Times columnist and Missing Manuals creator David Pogue gets you past three challenges: transferring your stuff, assembling Mac programs so you can do what you did with Windows, and learning your way around Mac OS X. Learning to use a Mac is not a piece of cake, but once you do, the rewards are oh-so-much better. No viruses, worms, or spyware. No questionable firewalls, inefficien

  19. Mac OS X Lion Server For Dummies

    CERN Document Server

    Rizzo, John

    2011-01-01

    The perfect guide to help administrators set up Apple's Mac OS X Lion Server With the overwhelming popularity of the iPhone and iPad, more Macs are appearing in corporate settings. The newest version of Mac Server is the ideal way to administer a Mac network. This friendly guide explains to both Windows and Mac administrators how to set up and configure the server, including services such as iCal Server, Podcast Producer, Wiki Server, Spotlight Server, iChat Server, File Sharing, Mail Services, and support for iPhone and iPad. It explains how to secure, administer, and troubleshoot the networ

  20. Laparoscopic cholecystectomy under epidural anesthesia: A feasibility study

    Directory of Open Access Journals (Sweden)

    Ranendra Hajong

    2014-01-01

    Full Text Available Background: Laparoscopic cholecystectomy (LC is normally performed under general anesthesia. But of late this operation has been tried under regional anesthesia successfully without any added complications like epidural anesthesia. Aims: The aim of the study was to study the feasibility of performing LC under epidural anesthesia in normal patients so that the benefits could be extended to those high-risk patients having symptomatic gallstone disease and compromised cardio-pulmonary status where general anesthesia is contraindicated. Materials and Methods: In all, 20 patients with the American Society of Anesthesiologist′s class I or II were enrolled in the study. The level of epidural block and satisfaction score, both for the patient and the surgeon, were noted in the study. Results: The LC was performed successfully under epidural anesthesia in all but two patients who had severe shoulder pain in spite of giving adequate analgesia and were converted to general anesthesia. Conclusions: The LC can be performed safely under epidural anesthesia with understanding between patient and surgeon. However, careful assessment of complications in the patients should be done to make the procedure safer.

  1. Cardiovascular, Antinociceptive and Sedative Effects of Medetomidine Infusion in Sevoflurane Anesthesia in Puppies

    Directory of Open Access Journals (Sweden)

    J Morgaz*, JM Domínguez, R Navarrete, JA Fernández-Sarmiento, P Muñoz-Rascón, RJ Gómez-Villamandos and MM Granados

    2013-07-01

    Full Text Available The objective of this study was to determine the effect of a constant rate infusion of medetomidine in the cortical brain activity and hemodynamic parameters in sevoflurane anesthetized puppies. Six puppies of the age of two weeks old were included in the study and were anaesthetized three times with sevoflurane. On the first anesthesia, each dog’s minimum alveolar concentration (MAC for sevoflurane was determined by the use of the tail clamp method. On the second anesthesia (sevoflurane, the puppies were anesthetized at each of five multiples of their individual’s MAC, 0.75, 1, 1.25, 1.5 and 1.75 MAC, and bispectral index and cardiorespiratory parameters were registered. On the third anesthesia (sevoflurane+ medetomidine, puppies were anesthetized at each of five multiples of their individual’s MAC, and medetomidine (5 µg/kg+2µg/kg/h was administered. Mild cardiovascular depression was observed in sevoflurane+medetomidine in comparison with sevoflurane. Cortical and antinociceptive effects were not observed with medetomidine infusion although a mature EEG response to noxious stimulation would not have developed in puppies. Central alpha-2 adrenoreceptors would be immature in puppies during the first two weeks of life, and for this reason, medetomidine would not produce sedative and analgesic effects in young puppies. More studies have to be performed to support this statement.

  2. Quantum MacWilliams Identities

    OpenAIRE

    Shor, Peter; Laflamme, Raymond

    1996-01-01

    We derive a relationship between two different notions of fidelity (entanglement fidelity and average fidelity) for a completely depolarizing quantum channel. This relationship gives rise to a quantum analog of the MacWilliams identities in classical coding theory. These identities relate the weight enumerator of a code to the one of its dual and, with linear programming techniques, provided a powerful tool to investigate the possible existence of codes. The same techniques can be adapted to ...

  3. Regional Anesthesia in Trauma Medicine

    OpenAIRE

    Loreto Lollo; Wu, Janice J.; Andreas Grabinsky

    2011-01-01

    Regional anesthesia is an established method to provide analgesia for patients in the operating room and during the postoperative phase. While regional anesthesia offers unique advantages, as shown by the recent military experience, it is not commonly utilized in the prehospital or emergency department setting. Most often, regional anesthesia techniques for traumatized patients are first utilized in the operating room for procedural anesthesia or for postoperative pain control. While infiltra...

  4. Anesthesia for interventional radiology

    International Nuclear Information System (INIS)

    We recognized that the complexity and surgical nature of many interventional radiology procedures dictate essential radiologic involvement into traditional anesthesiologic areas. They reviewed our experience with a variety of interventional procedures to document complications and problems related to anesthetic use (or misuse) and compile recommendations for rational monitoring and control for these procedures. In particular, the authors have studied complications of drug therapies and the treatment of these complications; use of complex anesthesia procedures (e.g., epidural anesthesia, succinylcholine blockage); reasons for choice of drugs (e.g., fentanyl vs meperidine vs morphine); and medico-legal aspects of radiologist performing traditional anesthesiology-type procedures

  5. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    International Nuclear Information System (INIS)

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  6. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    Energy Technology Data Exchange (ETDEWEB)

    Mahmoud, Mohamed [Cincinnati Children' s Hospital Medical Center, Department of Anesthesiology, Cincinnati, OH (United States); Towe, Christopher [Cincinnati Children' s Hospital Medical Center, Department of Pulmonary Medicine, Cincinnati, OH (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2015-07-15

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  7. Human factors research in anesthesia patient safety.

    OpenAIRE

    Weinger, M.B.; Slagle, J.

    2001-01-01

    Patient safety has become a major public concern. Human factors research in other high-risk fields has demonstrated how rigorous study of factors that affect job performance can lead to improved outcome and reduced errors after evidence-based redesign of tasks or systems. These techniques have increasingly been applied to the anesthesia work environment. This paper describes data obtained recently using task analysis and workload assessment during actual patient care and the use of cognitive ...

  8. Regional anesthesia techniques for ambulatory orthopedic surgery.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2012-02-03

    PURPOSE OF REVIEW: The purpose of this review is to present advances in the use of regional anesthetic techniques in ambulatory orthopedic surgery. New findings regarding the use of both neuraxial anesthesia and peripheral nerve block are discussed. RECENT FINDINGS: Neuraxial anesthesia: The use of short-acting local anesthetic agents such as mepivacaine, 2-chloroprocaine, and articaine permits rapid onset intrathecal anesthesia with early recovery profiles. Advantages and limitations of these agents are discussed.Peripheral nerve block: Peripheral nerve blocks in limb surgery have the potential to transform this patient cohort into a truly ambulatory, self-caring group. Recent trends and evidence regarding the benefits of regional anesthesia techniques are presented.Continuous perineural catheters permit extension of improved perioperative analgesia into the ambulatory home setting. The role and reported safety of continuous catheters are discussed. SUMMARY: In summary, shorter acting, neuraxial, local anesthetic agents, specific to the expected duration of surgery, may provide superior recovery profiles in the ambulatory setting. A trend towards more peripheral and selective nerve blocks exists. The infrapatellar block is a promising technique to provide analgesia following knee arthroscopy. Improved analgesia seen in the perioperative period can be safely and effectively extended to the postoperative period with the use of perineural catheters.

  9. Mac OS X Tiger for Unix Geeks

    CERN Document Server

    Jepson, Brian

    2005-01-01

    If you're one of the many Unix developers drawn to Mac OS X for its Unix core, you'll find yourself in surprisingly unfamiliar territory. Unix and Mac OS X are kissing cousins, but there are enough pitfalls and minefields in going from one to another that even a Unix guru can stumble, and most guides to Mac OS X are written for Mac aficionados. For a Unix developer, approaching Tiger from the Mac side is a bit like learning Russian by reading the Russian side of a Russian-English dictionary. Fortunately, O'Reilly has been the Unix authority for over 25 years, and in Mac OS X Tiger for Unix Gee

  10. Teach yourself visually Mac Mini

    CERN Document Server

    Hart-Davis, Guy

    2012-01-01

    The perfect how-to guide for visual learners Apple?s Mac Mini packs a powerful punch is in a small package, including both HDMI and Thunderbolt ports plus the acclaimed OS X. But if you want to get the very most from all this power and versatility, be sure to get this practical visual guide. With full-color, step-by-step instructions as well as screenshots and illustrations on every page, it clearly shows you how to accomplish tasks rather than burying you in pages of text. Discover helpful visuals and how-tos on the OS, hardware specs, Launchpad, the App Store, multimedia capabilities (such

  11. Web Development with the Mac

    CERN Document Server

    Vegh, Aaron

    2010-01-01

    Learn Web development the Apple way and build a business. With a focus on both coding and creative development, this in-depth guide thoroughly covers what you need to know to build winning websites for clients — from what it takes to bring a business online to how to make your site interactive to how to run a freelance web business. In between, you'll master the technical tools of the trade — such as HTML, CSS, JavaScript, PHP, and Ruby on Rails — and learn how to create beautiful interfaces using Photoshop . This book covers everything a fledgling web developer working on a Mac needs to launc

  12. Take control the Mac OS X lexicon

    CERN Document Server

    Zardetto, Sharon

    2009-01-01

    This ebook explains a little bit of everything; in fact, it's The Mac OS X (and then some) Lexicon because it's never just you and your Mac. It's you and your Mac and the Web, and your email, and that article you just read that threw 17 new acronyms at you or assumed that you knew all sorts of networking terms. Or it's you and your Mac and Finder features you've never touched, such as burn folders, smart folders, or proxy icons, and that mysterious Services submenu. This book is a great guide for Macintosh users everywhere who have trouble keeping up with the latest jargon, fo

  13. Mac protocols for cyber-physical systems

    CERN Document Server

    Xia, Feng

    2015-01-01

    This book provides a literature review of various wireless MAC protocols and techniques for achieving real-time and reliable communications in the context of cyber-physical systems (CPS). The evaluation analysis of IEEE 802.15.4 for CPS therein will give insights into configuration and optimization of critical design parameters of MAC protocols. In addition, this book also presents the design and evaluation of an adaptive MAC protocol for medical CPS, which exemplifies how to facilitate real-time and reliable communications in CPS by exploiting IEEE 802.15.4 based MAC protocols. This book wil

  14. Teach yourself visually MacBook Pro

    CERN Document Server

    Hart-Davis, Guy

    2014-01-01

    Clear instructions to help visual learners get started with their MacBook Pro Covering all the essential information you need to get up to speed with your MacBook Pro, this new edition provides you with the most up-to-date information on performing everyday tasks quickly and easily. From basics such as powering on or shutting down the MacBook Pro to more advanced tasks such as running Windows applications, this visual guide provides the help and support you need to confidently use your MacBook Pro to its full potential.Empowers you to perform everyday tasks quickly and easilyCovers new hardwa

  15. Take control of troubleshooting your Mac

    CERN Document Server

    Kissell, Joe

    2009-01-01

    Learn how to solve any Mac problem with Joe Kissell's expert advice! We may love our Macs, but they can still suffer significant problems. In this essential guide from best-selling author Joe Kissell, you'll learn 17 basic troubleshooting procedures and how to solve 9 common problems, along with an easy-to-follow way to troubleshoot novel problems. Whether your Mac won't turn on, experiences kernel panics repeatedly, or is glacially slow, this book has the calm, friendly advice you need to find a solution. Following in the footsteps of his critically acclaimed books Take Control of Mac OS X

  16. Macs all-in-one for dummies

    CERN Document Server

    Hutsko, Joe

    2014-01-01

    Your all-in-one guide to unleashing your Mac's full potential It's a Mac world out there. But if you haven't read the instruction manual, you may be neglecting some of your computer's coolest features. Turn to Macs All-in-One For Dummies' jam-packed guide to access the incredible tools within your computer. With this fully updated reference, you will learn how to use Launchpad and Mission Control; protect your Mac; back up and restore data with Time Machine; sync across devices in iCloud; import, organize, and share photos; direct in iMovie; compose in GarageBand; and so much more. The possi

  17. [Rocuronium anesthesia induced anaphylactic shock: a case report].

    Science.gov (United States)

    Qiu, Min; Zong, Ya-nan; Lu, Jian; Ma, Lu-lin; Zheng, Qing; Guo, Xiang-yang

    2015-10-18

    Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen, and it could be an unpredictable and life-threatening cause during anesthesia. The main purpose of this paper is to report a case of anaphylactic shock during the anesthesia induction and to review the prophylaxis and treatment of anaphylactic reactions and anaphylactoid reactions during the anesthesia period. A 63-year-old man, with a mass on his adrenal, was scheduled to a laparoscopic adrenal tumor excision. During the anesthesia induction period, after administrated sulfentanil, propofol and rocuronium, the blood pressure was decreased and the heart rate was increased. Then, the patient had rash on his whole body and developed an anaphylactic shock. After being treated with the anti-allergic agents and norepinephrine, the rash disappeared and the vital sign become stable. The patient felt nothing uncomfortable during the two weeks'follow-up. Anaphylactic reactions and anaphylactoid reactions are not rare during the anesthesia period. The most common inducements are muscle relaxant, latex and antibiotics. Anaphylactic reactions in the perioperative period are often serious and potentially life-threatening conditions, involving multiple organ systems in which the clinical manifestations are the consequence of the release of preformed mediators from mast cells and basophils. Before anesthesia, we should acquire the allergic history. During the anesthesia period, the vital sign and the skin should be observed carefully. PMID:26474637

  18. Hemodynamic effects of halothane-O2 and halothane-nitrous oxide anesthesia in swine. Comparison with equipotent isoflurane, enflurane, and sevoflurane anesthesis

    International Nuclear Information System (INIS)

    Fifteen micron diameter radionuclide labelled microspheres were injected into left atrium; and cerebral, myocardial, renal, adrenal and splanchnic organ hemodynamics were studied in nine healthy, isocapnic, normothermic swine while awake and during two levels (1.0 and 1.5 MAC) of anesthesia produced with halothane (HAL) vaporized in O2 alone and a mixture of 50% nitrous oxide in O2. Heart rate, cardiac output and arterial blood pressure were maintained better when equipotent anesthesia was produced using 50% N2O with HAL. Dose dependent vasodilatation occurred with HAL in all regions of the brain. Cerebral, cerebellar and brain stem blood flows at 1.5 MAC HAL-O2 were 135, 135 and 115% of respective control values. At 1.0 and 1.5 MAC, HAL-N2O cerebral blood flow was 204 and 153% of awake values. These effects on cerebral circulation were similar directionally to those of equipotent isoflurane and enflurane anesthesia. However, sevoflurane-O2 did not cause cerebral vasodilation. Myocardial blood flow decreased transmurally with HAL-O2 but during equipotent HAL-N2O anesthesia it was not different from the awake value. Renal blood flow was unaffected during both levels of HAL-O2 and HAL-N2O anesthesia. Adrenal blood flow increased with 1.5 MAC HAL-O2. Splenic, pancreatic, gastric and small intestinal blood flows decreased with HAL-O2 and HAL-N2O anesthesia. During HAL-N2O anesthesia, perfusion to these tissues was above values recorded during equipotent HAL-O2 anesthesia

  19. Administration of Anesthesia in a Patient with Allgrove Syndrome

    Directory of Open Access Journals (Sweden)

    Ayse B. Ozer

    2012-01-01

    Full Text Available The aim of the present paper is to report the anesthesia administration to a patient who was planned to undergo Heller myotomy for achalasia. There wasnot property in the patient whom allgrove syndrome was excepted any steroid treatment in preoperative period. The night before the operation 18 mg of prednisolone was administered intravenously. Induction of anesthesia was performed with thiopental sodium, vecuronium and fentanyl and the patient received endotracheal intubation. Eyes were taped closed and protected with ointment during surgery. Maintenance of anesthesia was achieved with 2% sevoflurane concentration in 50% O2-50% N2O. 25 mg of prednisolone was infused preoperatively, and intervention with insulin treatment was initiated when blood glucose level rose to 18 mmol/L at 2 hours. Safe anesthesia can be achieved by observing the preoperative development of tracheal aspiration, adrenal insufficiency and, autonomic dysfunction carefully and maintaining eye protection.

  20. Anesthesia and cor triatriatum

    OpenAIRE

    Federica Scavonetto; Tze Yeng Yeoh; Tasha L Welch; Weingarten, Toby N.; Juraj Sprung

    2014-01-01

    Aims and Objectives: Cor triatriatum sinistrum (CTS) and cor triatriatum dextrum (CTD) are rare congenital anomalies characterized by the presence of a perforated septum which divides the respective atrium into a proximal and distal chamber. This report reviews the perioperative course of patients with uncorrected cor triatriatum (CT) undergoing procedures requiring anesthesia. In addition, we performed a literature search that examines the experience of others regarding the peri-operative co...

  1. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  2. The National Anesthesia Clinical Outcomes Registry.

    Science.gov (United States)

    Liau, Adrian; Havidich, Jeana E; Onega, Tracy; Dutton, Richard P

    2015-12-01

    The Anesthesia Quality Institute (AQI) was chartered in 2008 by the American Society of Anesthesiologists to develop the National Anesthesia Clinical Outcomes Registry (NACOR). In this Technical Communication, we will describe how data enter NACOR, how they are authenticated, and how they are analyzed and reported. NACOR accepts case-level administrative, clinical, and quality capture data from voluntarily participating anesthesia practices and health care facilities in the United States. All data are transmitted to the AQI in summary electronic files generated by billing, quality capture, and electronic health care record software, typically on a monthly basis. All data elements are mapped to fields in the NACOR schema in accordance with a publicly available data dictionary. Incoming data are loaded into NACOR by AQI technologists and are subject to both manual and automated review to identify systematically missing elements, miscoding, and inadvertent corruption. Data are deidentified in compliance with Health Insurance Portability and Accountability Act regulations. The database server of AQI, which houses the NACOR database, is protected by 2 firewalls within the American Society of Anesthesiologists' network infrastructure; this system has not been breached. The NACOR Participant User File, a deidentified case-level dataset of information from NACOR, is available to researchers at participating institutions. NACOR architecture and the nature of the Participant User File include both strengths and weaknesses. PMID:26579661

  3. LabVIEW control solutions on Mac

    OpenAIRE

    Salzmann, Christophe

    2008-01-01

    This presentation show the successful usage of LabVIEW on the Mac with a specific focus on control solutions. First, 15 years of control solutions with LabVIEW on the Mac are reviewed. Then it presents current DAQmx base solutions, using as an example a Spider crane (see http://lawww.epfl.ch/page4506.html) and an inverted pendulum.

  4. George MacDonald's Estimate of Childhood

    Science.gov (United States)

    Pridmore, John

    2007-01-01

    The nineteenth-century fantasy writer George MacDonald believed that "it is better to be a child in a green field than a knight of many orders." In this paper, I shall explore the bearing of this high estimate of childhood on spiritual education. MacDonald explores the spirituality of the child in his essay "A Sketch of Individual Development" and…

  5. Application of high level of nursing service in the post-anesthesia care unit%优质护理服务在麻醉恢复室的应用

    Institute of Scientific and Technical Information of China (English)

    邓曼丽; 宿文清; 赵燕

    2013-01-01

    Objective To discuss the method and measures of high-quality nursing service in the postanesthesia care unit.Methods Many methods were adopted,that carried out the whole without aperture (holistic) nursing in the anesthesia recovery period,set up specialized nursing quality check list of PACU,strengthened the body and mind warm service,made nurse-patient communication card,paid attention to the five key links in the anesthesia recovery period,and used optimized of nursing documents writing and other new nursing measures.Results The degree of satisfaction among patients and anesthesiologists was significantly improved after the high-quality nursing service was implemented.And no nursing error,accident,and complaints occurred.Conclusions The implementation of high-quality nursing service will be beneficial to meeting the target:“ satisfy the patients,the society and the government”.%目的 探讨麻醉恢复室开展优质护理服务的方法和措施.方法 开展麻醉恢复期全程无缝隙护理,建立麻醉恢复室专科护理质量检查表,加强麻醉恢复室“身心温暖服务”,制作患者沟通卡片,把握好恢复期易出现危险的“五关”,简化护理文书书写等优质护理服务新措施.结果 麻醉恢复室实行优质护理服务后,患者和麻醉医生满意度得到明显提高.无护理差错、事故,无护理投诉.结论 开展麻醉恢复室优质护理服务,并持续工作改进,有利于实现“患者满意,社会满意,政府满意”的活动目标.

  6. Guidelines for administration of local anesthesia for dermatosurgery and cosmetic dermatology procedures

    Directory of Open Access Journals (Sweden)

    Mysore Venkataram

    2009-08-01

    Full Text Available Introduction, definition, rationale and scope: Dermatosurgery and Cosmetic dermatology procedures are being performed by increasing number of dermatologists. Most dermatosurgeries are performed in an outpatient setting and as day care surgeries, under local anesthesia. Hence, it is important to improve patient comfort during all procedures. These guidelines seek to lay down directives in the use of local anesthesia, outline the different local anesthetics, the mode of administration, complications arising out of such procedure and management of the same. Facility for administration of local anesthesia: Local anesthesia is usually administered in the dermatologist′s procedure room. The room should be equipped to deal with any emergencies arising from administration of local anesthesia. Qualifications of local anesthesia administrator: Local anesthesia administrator is a person who applies or injects local anesthetic agent for causing analgesia. Procedures done under local anesthesia are classified as Level I office procedures and require the administrator to have completed a course in Basic Cardiac Life Support (BCLS. Evaluation of patients for topical or infiltrative anesthesia: Details of patient′s past medical history and history of medications should be noted. Allergy to any medications should be specifically enquired and documented. Patients for tumescent anesthesia need additional precautions to be observed as described in these guidelines. Methods of administration of local anesthesia: Different methods include topical anesthesia, field block, ring block, local infiltration and nerve block. Also, it includes use of local anesthetics for anesthetizing oral and genital mucosa. Tumescent anesthesia is a special form of local anesthesia used in liposuction and certain selected procedures. Local anesthetic agents: Different local anesthetics are available such as lignocaine, prilocaine, bupivacaine. The dermatologist should be aware of the

  7. Safe Anesthesia For Every Tot

    DEFF Research Database (Denmark)

    Weiss, Markus; Vutskits, Laszlo; Hansen, Tom G;

    2015-01-01

    PURPOSE OF REVIEW: The term 'safe use of anesthesia in children is ill-defined and requires definition of and focus on the 'safe conduct of pediatric anesthesia'. RECENT FINDINGS: The Safe Anesthesia For Every Tot initiative (www.safetots.org) has been set up during the last year to focus on the...... improvement of teaching, training, education and supervision of the safe conduct of pediatric anesthesia are the main goals of the safetots.org initiative. SUMMARY: This initiative addresses the well known perioperative risks in young children, perioperative causes for cerebral morbidity as well as gaps in...

  8. Anesthesia management in a pediatric patient with Dandy-Walker syndrome

    OpenAIRE

    Çelik, Feyzi; Tüfek, Adnan; Temel, Vildan; Akdemir, Salim; Yıldırım, Zeynep Baysal; Kavak, Gönül Ölmez

    2011-01-01

    General anesthesia management of patients with Dandy-Walker syndrome is important since intubation may be difficult due to concomitant anomalies such as hydrocephalus, micrognathia and cleft palate. It should be considered that these patients may require postoperative intensive care support. In this article, anesthesia management of a patient with Dandy-Walker syndrome underwent persistent ventriculo-peritoneal shunt was presented.

  9. An overview of anesthetic procedures, tools, and techniques in ambulatory care

    Directory of Open Access Journals (Sweden)

    Messieha Z

    2015-01-01

    Full Text Available Zakaria Messieha Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA Abstract: Ambulatory surgical and anesthesia care (ASAC, also known as Same Day Surgery or Day Care in some countries, is the fastest growing segment of ambulatory surgical and anesthesia care. Over 50 million ambulatory surgical procedures are conducted annually comprising over 60% of all anesthesia care with an impressive track record of safety and efficiency. Advances in ambulatory anesthesia care have been due to newer generation of inhalation and intravenous anesthetics as well as airway management technology and techniques. Successful ambulatory anesthesia care relies on patient selection, adequate facilities, highly trained personnel and quality improvement policies and procedures. Favoring one anesthetic technique over the other should be patient and procedure-specific. Effective management of post-operative pain as well as nausea and vomiting are the final pieces in assuring success in ambulatory anesthesia care. Keywords: ambulatory anesthesia, out-patient anesthesia, Day-Care anesthesia

  10. Anesthesia - what to ask your doctor - adult

    Science.gov (United States)

    ... that I am having? General anesthesia Spinal or epidural anesthesia Conscious sedation When do I need to stop ... to my stomach? If I have spinal or epidural anesthesia, will I have a headache afterwards? What if ...

  11. Anesthesia - what to ask your doctor - child

    Science.gov (United States)

    ... my child is having? General anesthesia Spinal or epidural anesthesia Conscious sedation When does my child need to ... upset stomach? If my child had spinal or epidural anesthesia, will my child have a headache afterwards? What ...

  12. Anecdotes from the history of anesthesia in dentistry.

    OpenAIRE

    Trieger, N.

    1995-01-01

    I believe that dentists have made important contributions to anesthesiology and patient care. Medical anesthesiology is now being required to provide more same-day or ambulatory care. Where it was once good sport to criticize dentists providing brief anesthesia services for their patients, it has now become appropriate for physician anesthesiologists to use shorter-acting agents, improved physiologic monitoring, reversal agents, and early discharge as part of their care of patients. Anecdotes...

  13. Comparison of CSMA based MAC protocols of wireless sensor networks

    CERN Document Server

    singh, Himanshu

    2012-01-01

    Energy conservation has been an important area of interest in Wireless Sensor networks (WSNs). Medium Access Control (MAC) protocols play an important role in energy conservation. In this paper, we describe CSMA based MAC protocols for WSN and analyze the simulation results of these protocols. We implemented S-MAC, T-MAC, B-MAC, B-MAC+, X-MAC, DMAC and Wise-MAC in TOSSIM, a simulator which unlike other simulators simulates the same code running on real hardware. Previous surveys mainly focused on the classification of MAC protocols according to the techniques being used or problem dealt with and presented a theoretical evaluation of protocols. This paper presents the comparative study of CSMA based protocols for WSNs, showing which MAC protocol is suitable in a particular environment and supports the arguments with the simulation results. The comparative study can be used to find the best suited MAC protocol for wireless sensor networks in different environments.

  14. Anesthesia for bronchoscopy.

    Science.gov (United States)

    Abdelmalak, Basem B; Gildea, Thomas R; Doyle, D John

    2012-01-01

    Bronchoscopic procedures are at times intricate and the patients often very ill. These factors and an airway shared with the pulmonologist present a clear challenge to anesthesiologists. The key to success lies in the understanding of both the underlying pathology and procedure being performed combined with frequent two-way communication between the anesthesiologist and the pulmonologist. Above all, vigilance and preparedness are paramount. Topics discussed in this review include anesthesia for advanced diagnostic procedures as well as for interventional/ therapeutic procedures. The latter includes bronchoscopic tracheal balloon dilation, tracheobronchial stenting, endobronchial electrocautery, bronchoscopic cryotherapy and other techniques. Special situations, such as tracheoesophageal fistula and mediastinal masses, are also considered. PMID:22762465

  15. Anesthesia for thoracoscopic surgery

    Directory of Open Access Journals (Sweden)

    Conacher I

    2007-01-01

    Full Text Available Anesthesia for thoracoscopy is based on one lung ventilation. Lung separators in the airway are essential tools. An anatomical shunt as a result of the continued perfusion of a non-ventilated lung is the principal intraoperative concern. The combination of equipment, technique and process increase risks of hypoxia and dynamic hyperinflation, in turn, potential factors in the development of an unusual form of pulmonary edema. Analgesia management is modelled on that shown effective and therapeutic for thoracotomy. Perioperative management needs to reflect the concern for these complex, and complicating, processes to the morbidity of thoracoscopic surgery.

  16. Paediatric Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Rakhee Goyal

    2008-01-01

    Full Text Available Paediatric spinal anesthesia is not only a safe alternative to general anaesthesia but often the anaesthesia technique of choice in many lower abdominal and lower limb surgeries in children. The misconception regarding its safety and feasibility is broken and is now found to be even more cost-effective. It is a much preferred technique especially for the common daycase surgeries generally performed in the paediatric age group. There is no require-ment of any additional expensive equipment either and this procedure can be easily performed in peripheral centers. However, greater acceptance and experience is yet desired for this technique to become popular.

  17. Beginning Mac OS X Snow Leopard programming

    CERN Document Server

    Trent, Michael

    2010-01-01

    Michael Trent is a technical reviewer for numerous books and magazine articles and the coauthor of Beginning Mac OS X Programming with Drew McCormack. Drew McCormack is an experienced computational scientist, founder of the ""The Mental Faculty""-an independent company developing software for the Mac and iPhone-and the coauthor of Beginning Mac OS X Programming with Michael Trent. Wrox Beginning guides are crafted to make learning programming languages and technologies easier than you think, providing a structured, tutorial format that will guide you through all the techniques involved.

  18. Mac OS X for Unix Geeks (Leopard)

    CERN Document Server

    Rothman, Ernest E; Rosen, Rich

    2009-01-01

    If you've been lured to Mac OS X because of its Unix roots, this invaluable book serves as a bridge between Apple's Darwin OS and the more traditional Unix systems. The new edition offers a complete tour of Mac OS X's Unix shell for Leopard and Tiger, and helps you find the facilities that replace or correspond to standard Unix utilities. Learn how to compile code, link to libraries, and port Unix software to Mac OS X and much more with this concise guide.

  19. Fast arithmetic in MacLISP

    Science.gov (United States)

    Steele, G. L., Jr.

    1977-01-01

    MacLISP provides a compiler which produces numerical code competitive in speed with some FORTRAN implementations and yet compatible with the rest of the MacLISP system. All numerical programs can be run under the MacLISP interpreter. Additional declarations to the compiler specify type information which allows the generation of optimized numerical code which generally does not require the garbage collection of temporary numerical results. Array accesses are almost as fast as in FORTRAN, and permit the use of dynamically allocated arrays of varying dimensions. The implementation decisions regarding user interface, data representations, and interfacing conventions are discussed which allow the generation of fast numerical LISP code.

  20. Learn Office 2011 for Mac OS X

    CERN Document Server

    Hart-Davis, Guy

    2011-01-01

    Office for Mac remains the leading productivity suite for Mac, with Apple's iWork and the free OpenOffice.org trailing far behind. And now it's being updated with a cleaner interface and more compatibility with Exchange and SharePoint. Learn Office 2011 for Mac OS X offers a practical, hands-on approach to using Office 2011 applications to create and edit documents and get work done efficiently. You'll learn how to customize Office, design, create, and share documents, manipulate data in a spreadsheet, and create lively presentations. You'll also discover how to organize your email, contacts,

  1. Office 2008 for Mac for dummies

    CERN Document Server

    LeVitus, Bob

    2013-01-01

    Office 2008 for Mac is here, with great new enhancements to all your favorite office productivity tools. Who better than "Dr. Mac, "Bob LeVitus, to show you how to load and use them all? From choosing the best version for your needs to managing your life with your online calendar, Office 2008 For Mac For Dummies covers what you need to know. It compares the Student/Teacher Edition, Standard Edition, and Professional Edition, then walks you through installing your preferred version and keeping it up to date. You'll find out all the things you can do with Word, Excel, PowerPoint, and Entourage,

  2. Mac OS X Lion portable genius

    CERN Document Server

    Spivey, Dwight

    2012-01-01

    Two e-books, Mac OS X Lion Portable Genius and MacBook Pro Portable Genius, Third Edition, bundled in one package Books in the Portable Genius series provide readers with the most accessible, useful information possible, including plenty of tips and techniques for the most-used features in a product or software. These e-books will show you what you may not find out by just working with your MacBook Pro and OS X Lion. Genius icons present smart or innovative ways to do something, saving time and hassle. Easy-to-find information gives you the essentials plus insightful tips on how to navigate

  3. Repetitive Pediatric Anesthesia in a Non-Hospital Setting

    International Nuclear Information System (INIS)

    Purpose: Repetitive sedation/anesthesia (S/A) for children receiving fractionated radiation therapy requires induction and recovery daily for several weeks. In the vast majority of cases, this is accomplished in an academic center with direct access to pediatric faculty and facilities in case of an emergency. Proton radiation therapy centers are more frequently free-standing facilities at some distance from specialized pediatric care. This poses a potential dilemma in the case of children requiring anesthesia. Methods and Materials: The records of the Indiana University Health Proton Therapy Center were reviewed for patients requiring anesthesia during proton beam therapy (PBT) between June 1, 2008, and April 12, 2012. Results: A total of 138 children received daily anesthesia during this period. A median of 30 fractions (range, 1-49) was delivered over a median of 43 days (range, 1-74) for a total of 4045 sedation/anesthesia procedures. Three events (0.0074%) occurred, 1 fall from a gurney during anesthesia recovery and 2 aspiration events requiring emergency department evaluation. All 3 children did well. One aspiration patient needed admission to the hospital and mechanical ventilation support. The other patient returned the next day for treatment without issue. The patient who fell was not injured. No patient required cessation of therapy. Conclusions: This is the largest reported series of repetitive pediatric anesthesia in radiation therapy, and the only available data from the proton environment. Strict adherence to rigorous protocols and a well-trained team can safely deliver daily sedation/anesthesia in free-standing proton centers

  4. General versus epidural anesthesia for lumbar microdiscectomy.

    Science.gov (United States)

    Ulutas, Murat; Secer, Mehmet; Taskapilioglu, Ozgur; Karadas, Soner; Akyilmaz, Ahmet Aykut; Baydilek, Yunus; Kocamer, Betul; Ozboz, Ayse; Boyaci, Suat

    2015-08-01

    This study was a retrospective analysis of 850 lumbar microdiscectomy (LMD) under epidural anesthesia (EA; n=573) or general anesthesia (GA; n=277) performed by the same surgeon and paid by invoice to the Social Security Institution of the Turkish Republic between April 2003 and May 2013. Although GA is the most frequently used method of anesthesia during LMD, the choice of regional anesthetia (epidural, spinal or a combination of these) differs between surgeons and anesthetists. Studies have reported that EA in surgery for lumbar disc herniation may be more reliable than GA, as it enables the surgeon to communicate with the patient during surgery, but few studies have compared the costs of these two anesthetic methods in LMD. We found that EA patient costs were significantly lower than GA patient costs (p0.05). The anesthetic method used during LMD affected the complication rate, cost and efficiency of operating room use. We suggest that EA is an anesthetic method that can contribute to health care cost savings and enable LMD to be completed with less nerve root manipulation and more comfort, efficacy, reliability and cost efficiency without affecting the success rate of the surgical procedure. PMID:26067543

  5. H-MAC: A Hybrid MAC Protocol for Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    S. Mehta

    2010-03-01

    Full Text Available In this paper, we propose a hybrid medium access control protocol (H-MAC for wireless sensor networks. It is based on the IEEE 802.11’s power saving mechanism (PSM and slotted aloha, andutilizes multiple slots dynamically to improve performance. Existing MAC protocols for sensor networks reduce energy consumptions by introducing variation in an active/sleep mechanism. But they may notprovide energy efficiency in varying traffic conditions as well as they did not address Quality of Service (QoS issues. H-MAC, the propose MAC protocol maintains energy efficiency as well as QoS issues like latency, throughput, and channel utilization. Our numerical results show that H-MAC has significant improvements in QoS parameters than the existing MAC protocols for sensor networks while consuming comparable amount of energy.

  6. CR-MAC: A multichannel MAC protocol for cognitive radio ad hoc networks

    CERN Document Server

    Kamruzzaman, S M

    2010-01-01

    This paper proposes a cross-layer based cognitive radio multichannel medium access control (MAC) protocol with TDMA, which integrate the spectrum sensing at physical (PHY) layer and the packet scheduling at MAC layer, for the ad hoc wireless networks. The IEEE 802.11 standard allows for the use of multiple channels available at the PHY layer, but its MAC protocol is designed only for a single channel. A single channel MAC protocol does not work well in a multichannel environment, because of the multichannel hidden terminal problem. Our proposed protocol enables secondary users (SUs) to utilize multiple channels by switching channels dynamically, thus increasing network throughput. In our proposed protocol, each SU is equipped with only one spectrum agile transceiver, but solves the multichannel hidden terminal problem using temporal synchronization. The proposed cognitive radio MAC (CR-MAC) protocol allows SUs to identify and use the unused frequency spectrum in a way that constrains the level of interference...

  7. H-MAC: A Hybrid MAC Protocol for Wireless Sensor Networks

    CERN Document Server

    Mehta, S; 10.5121/ijcnc.2010.2208

    2010-01-01

    In this paper, we propose a hybrid medium access control protocol (H-MAC) for wireless sensor networks. It is based on the IEEE 802.11's power saving mechanism (PSM) and slotted aloha, and utilizes multiple slots dynamically to improve performance. Existing MAC protocols for sensor networks reduce energy consumptions by introducing variation in an active/sleep mechanism. But they may not provide energy efficiency in varying traffic conditions as well as they did not address Quality of Service (QoS) issues. H-MAC, the propose MAC protocol maintains energy efficiency as well as QoS issues like latency, throughput, and channel utilization. Our numerical results show that H-MAC has significant improvements in QoS parameters than the existing MAC protocols for sensor networks while consuming comparable amount of energy.

  8. Anesthesia and cor triatriatum

    Directory of Open Access Journals (Sweden)

    Federica Scavonetto

    2014-01-01

    Full Text Available Aims and Objectives: Cor triatriatum sinistrum (CTS and cor triatriatum dextrum (CTD are rare congenital anomalies characterized by the presence of a perforated septum which divides the respective atrium into a proximal and distal chamber. This report reviews the perioperative course of patients with uncorrected cor triatriatum (CT undergoing procedures requiring anesthesia. In addition, we performed a literature search that examines the experience of others regarding the peri-operative course of patients with CT. Materials and Methods: A computerized search of a medical record database was conducted to identify patients with a clinical diagnosis of uncorrected CTD and CTS undergoing surgical procedures. Descriptive statistics were used. Results: We identified 12 adult patients with asymptomatic CTS (n = 7 and CTD (n = 5 who underwent 23 anesthetics. There were no perioperative complications which could be attributed directly to the anatomy of CT. Conclusions: Our observation and review of the literature suggest that patients with asymptomatic CT typically tolerate anesthesia and surgical procedures well.

  9. Learn Mac OS X Snow Leopard

    CERN Document Server

    Meyers, Scott

    2009-01-01

    You're smart and savvy, but also busy. This comprehensive guide to Apple's Mac OS X 10.6, Snow Leopard, gives you everything you need to know to live a happy, productive Mac life. Learn Mac OS X Snow Leopard will have you up and connected lickity split. With a minimum of overhead and a maximum of useful information, you'll cover a lot of ground in the time it takes other books to get you plugged in. If this isn't your first experience with Mac OS X, skip right to the "What's New in Snow Leopard" sections. You may also find yourself using this book as a quick refresher course or a way

  10. Teach yourself visually MacBook Air

    CERN Document Server

    Hart-Davis, Guy

    2013-01-01

    Get the most out of the latest MacBook Air with this easy-to-read visual guide Who doesn't love the MacBook Air? It's light as a feather, yet delivers heavyweight functionality. If you want clear, practical, visual instructions on how to use your new MacBook Air, this is the book for you. Using tons of illustrations and step-by-step explanations, Teach Yourself VISUALLY MacBook Air gets you up and running by clearly showing you how to do everything. From the basics to everything the new OS X operating system brings to the table, this book guides you through. Walks you through all the new fea

  11. Enhanced Sleep Mode MAC Control for EPON

    DEFF Research Database (Denmark)

    Yan, Ying; Dittmann, Lars

    2011-01-01

    This paper introduces sleep mode operations for EPON. New MAC control functions are proposed to schedule sleep periods. Traffic profiles are considered to optimize energy efficiency and network performances. Simulation results are analyzed in OPNET modeler.......This paper introduces sleep mode operations for EPON. New MAC control functions are proposed to schedule sleep periods. Traffic profiles are considered to optimize energy efficiency and network performances. Simulation results are analyzed in OPNET modeler....

  12. Macintosh Troubleshooting Pocket Guide for Mac OS

    CERN Document Server

    Lerner, David; Corporation, Tekserve

    2009-01-01

    The Macintosh Troubleshooting Pocket Guide covers the most common user hardware and software trouble. It's not just a book for Mac OS X (although it includes tips for OS X and Jaguar), it's for anyone who owns a Mac of any type-- there are software tips going back as far as OS 6. This slim guide distills the answers to the urgent questions that Tekserve's employee's answer every week into a handy guide that fits in your back pocket or alongside your keyboard.

  13. WLAN throughput improvement via distributed queuing MAC

    OpenAIRE

    Alonso Zárate, Luis Gonzaga; Ferrús Ferré, Ramón Antonio; Agustí Comes, Ramon

    2005-01-01

    This paper analyzes the performance of a MAC scheme for wireless local area networks (WLANs) that makes use of distributed queues to improve radio channel utilization. Analytical values for the maximum throughput performance are derived as a function of the system parameters. The obtained results show that the proposed scheme outperforms the legacy 802.11 MAC protocol in terms of maximum stable throughput. This benefit is obtained from eliminating back-off periods and collisions in data packe...

  14. Variable TDMA MAC Protocol For WDM EPON

    Institute of Scientific and Technical Information of China (English)

    Minsuk; Jung; Yongseok; Chang; Jonghoon; Eom; Sungho; Kim

    2003-01-01

    A MAC(Media Access Control) protocol, one of the most important technologies for an EPON(Ethernet Passive Optical Network), contains a scheduling algorithm to avoid collisions in shared links and assigns an effective bandwidth when ONUs (Optical Network Units) transfer signals upward. The current paper proposes a MAC Protocol that operates a TDMA(Time method with a variable slot assignment to overcome short of bandwidth using by the number of n wavelength., the next generation access network. To verify ...

  15. 12 CFR 615.5174 - Farmer Mac securities.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Farmer Mac securities. 615.5174 Section 615....5174 Farmer Mac securities. (a) General authority. You may purchase and hold mortgage securities that... Corporation (Farmer Mac securities). You may purchase and hold Farmer Mac securities for the purposes...

  16. Updates of Topical and Local Anesthesia Agents.

    Science.gov (United States)

    Boyce, Ricardo A; Kirpalani, Tarun; Mohan, Naveen

    2016-04-01

    As described in this article, there are many advances in topical and local anesthesia. Topical and local anesthetics have played a great role in dentistry in alleviating the fears of patients, eliminating pain, and providing pain control. Many invasive procedures would not be performed without the use and advances of topical/local anesthetics. The modern-day dentist has the responsibility of knowing the variety of products on the market and should have at least references to access before, during, and after treatment. This practice ensures proper care with topical and local anesthetics for the masses of patients entering dental offices worldwide. PMID:27040295

  17. Anesthesia during and Immediately after Spaceflight

    Science.gov (United States)

    Seubert, Christoph N.; Price, Catherine; Janelle, Gregory M.

    2006-01-01

    The increasing presence of humans in space and long-duration manned missions to the Moon or Mars pose novel challenges to the delivery of medical care. Even now, cumulative person-days in space exceed 80 years and preparations for a return to the Moon are actively underway. Medical care after an emergent de-orbit or an accident during a non-nominal landing must not only address the specific disease or injuries but also the challenges posed by physiologic adaptations to microgravity. In the highly autonomous situation of a long-term space mission the situation is even more complex, because personnel, equipment, specific training, and clinical experience are by definition limited. To summarize our current knowledge specifically for anesthetic care during and immediately after spaceflight, we will review physiologic adaptations to microgravity with particular emphasis on the resulting anesthetic risks, discuss veterinary experiences with anesthesia in weightlessness or in animals adapted to microgravity, describe current research that pertains to anesthesia and spaceflight and point out unresolved questions for future investigation.

  18. Mac protocols for wireless sensor network (wsn): a comparative study

    International Nuclear Information System (INIS)

    Data communication between nodes is carried out under Medium Access Control (MAC) protocol which is defined at data link layer. The MAC protocols are responsible to communicate and coordinate between nodes according to the defined standards in WSN (Wireless Sensor Networks). The design of a MAC protocol should also address the issues of energy efficiency and transmission efficiency. There are number of MAC protocols that exist in the literature proposed for WSN. In this paper, nine MAC protocols which includes S-MAC, T-MAC, Wise-MAC, Mu-MAC, Z-MAC, A-MAC, D-MAC, B-MAC and B-MAC+ for WSN have been explored, studied and analyzed. These nine protocols are classified in contention based and hybrid (combination of contention and schedule based) MAC protocols. The goal of this comparative study is to provide a basis for MAC protocols and to highlight different mechanisms used with respect to parameters for the evaluation of energy and transmission efficiency in WSN. This study also aims to give reader a better understanding of the concepts, processes and flow of information used in these MAC protocols for WSN. A comparison with respect to energy reservation scheme, idle listening avoidance, latency, fairness, data synchronization, and throughput maximization has been presented. It was analyzed that contention based MAC protocols are less energy efficient as compared to hybrid MAC protocols. From the analysis of contention based MAC protocols in term of energy consumption, it was being observed that protocols based on preamble sampling consume lesser energy than protocols based on static or dynamic sleep schedule. (author)

  19. Patient satisfaction and positive patient outcomes in ambulatory anesthesia

    OpenAIRE

    Wong, Jean; Shah, Ushma; Wong, David

    2015-01-01

    Ushma Shah, David T Wong, Jean Wong Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Abstract: Most surgeries in North America are performed on an ambulatory basis, reducing health care costs and increasing patient comfort. Patient satisfaction is an important outcome indicator of the quality of health care services incorporated by the American Society of Anesthesiologists (ASA). Patient satisfaction is a complex concep...

  20. SA-MAC:Self-Stabilizing Adaptive MAC Protocol for Wireless Sensor Networks

    Institute of Scientific and Technical Information of China (English)

    波澄; 韩君泽; 李向阳; 王昱; 肖波

    2014-01-01

    A common method of prolonging the lifetime of wireless sensor networks is to use low power duty cycling protocol. Existing protocols consist of two categories: sender-initiated and receiver-initiated. In this paper, we present SA-MAC, a self-stabilizing adaptive MAC protocol for wireless sensor networks. SA-MAC dynamically adjusts the transmission time-slot, waking up time-slot, and packet detection pattern according to current network working condition, such as packet length and wake-up patterns of neighboring nodes. In the long run, every sensor node will find its own transmission phase so that the network will enter a stable stage when the network load and qualities are static. We conduct extensive experiments to evaluate the energy consumption, packet reception rate of SA-MAC in real sensor networking systems. Our results indicate that SA-MAC outperforms other existing protocols.

  1. Creation of an integrated outcome database for pediatric anesthesia.

    Science.gov (United States)

    Cravero, Joseph P; Sriswasdi, Patcharee; Lekowski, Rebecca; Carpino, Elizabeth; Blum, Richard; Askins, Nissa; Zurakowski, David; Sinnott, Sean

    2016-04-01

    Outcome analysis is essential to health care quality improvement efforts. Pediatric anesthesia faces unique challenges in analyzing outcomes. Anesthesia most often involves a one-time point of care interaction where work flow precludes detailed feedback to care givers. In addition, pediatric outcome evaluations must take into account patients' age, development, and underlying illnesses when attempting to establish benchmarks. The deployment of electronic medical records, including preoperative, operative, and postoperative data, offers an opportunity for creating datasets large and inclusive enough to overcome these potential confounders. At our institution, perioperative data exist in five distinct environments. In this study, we describe a method to integrate these datasets into a single web-based relational database that provides researchers and clinicians with regular anesthesia outcome data that can be reviewed on a daily, weekly, or monthly basis. Because of its complexity, the project also entailed the creation of a 'dashboard,' allowing tracking of data trends and rapid feedback of measured metrics to promote and sustain improvements. We present the first use of such a database and dashboard for pediatric anesthesia professionals as well as successfully demonstrating its capabilities to perform as described above. PMID:26956515

  2. Patient satisfaction and positive patient outcomes in ambulatory anesthesia

    Directory of Open Access Journals (Sweden)

    Shah U

    2015-04-01

    Full Text Available Ushma Shah, David T Wong, Jean Wong Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Abstract: Most surgeries in North America are performed on an ambulatory basis, reducing health care costs and increasing patient comfort. Patient satisfaction is an important outcome indicator of the quality of health care services incorporated by the American Society of Anesthesiologists (ASA. Patient satisfaction is a complex concept that is influenced by multiple factors. A patient's viewpoint and knowledge plays an influential role in patient satisfaction with ambulatory surgery. Medical optimization and psychological preparation of the patient plays a pivotal role in the success of ambulatory surgery. Postoperative pain, nausea, and vomiting are the most important symptoms for the patient and can be addressed by multimodal drug regimens. Shared decision making, patient–provider relationship, communication, and continuity of care form the main pillars of patient satisfaction. Various psychometrically developed instruments are available to measure patient satisfaction, such as the Iowa Satisfaction with Anesthesia Scale and Evaluation du Vecu de I'Anesthesie Generale, but none have been developed specifically for ambulatory surgery. The ASA has made recommendations for data collection for patient satisfaction surveys and emphasized the importance of reporting the data to the Anesthesia Quality Institute. Future research is warranted to develop a validated tool to measure patient satisfaction in ambulatory surgery. Keywords: patient, satisfaction, anesthesia, outcomes, questionnaire, perspectives

  3. Transverse myelitis following spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Jha Sanjeev

    2006-01-01

    Full Text Available Spinal anesthesia is widely used during surgical procedures. It is generally safe and the frequency of severe, permanent neurological complications associated with it has been reported to be extremely low. We report a patient, who developed paraplegia following spinal anesthesia. A 29-year-old male was referred with acute, flaccid, sensory motor paraplegia, with bladder and bowel involvement. He developed this immediately after an operation for inguinal hernia under spinal anesthesia. Spinal magnetic resonance imaging revealed hemorrhagic myelitis in the conus at D12. He was referred after he did not respond to intravenous methylprednisolone for 10 days. This case brings up the difficulty encountered in determination of the interspace used for spinal anesthesia and the potential for traumatic injury to the spinal cord. It also demonstrates the tragic outcome after a clinician violates some important, standard and established guidelines.

  4. Clinical relevance in anesthesia journals

    DEFF Research Database (Denmark)

    Lauritsen, Jakob; Møller, Ann M

    2006-01-01

    The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles.......The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles....

  5. Anesthesia considerations in the obese gravida.

    LENUS (Irish Health Repository)

    Tan, Terry

    2011-12-01

    Obesity is associated with serious morbidity during pregnancy, and obese women also are at a high risk of developing complications during labor, leading to an increased risk for instrumental and Cesarean deliveries. The engagement of the obstetrical anesthetist in the management of this group of high-risk patients should be performed antenatally so that an appropriate management strategy can be planned in advance to prevent an adverse outcome. Good communication between all care providers is essential. The obese patient in labor should be encouraged to have a functioning epidural catheter placed early in labor. Apart from providing analgesia and alleviating physiological derangements during labor, the presence of a functioning epidural catheter can also be used to induce anesthesia quickly in the event of an emergency cesarean section, thus avoiding a general anesthesia, which has exceedingly high risks in the obese parturient. Successful management of the obese patient necessitates a comprehensive strategy that encompasses a multidisciplinary and holistic approach from all care-providers.

  6. Simulation in teaching regional anesthesia: current perspectives

    Directory of Open Access Journals (Sweden)

    Udani AD

    2015-08-01

    Full Text Available Ankeet D Udani,1 T Edward Kim,2,3 Steven K Howard,2,3 Edward R Mariano2,3On behalf of the ADAPT (Anesthesiology-Directed Advanced Procedural Training Research Group1Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA; 2Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; 3Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USAAbstract: The emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine. To date, there have been a wide variety of simulation applications in this field, and efficacy has largely been assumed. However, a thorough review of the literature reveals that effective teaching strategies, including simulation, in regional anesthesiology and acute pain medicine are not established completely yet. Future research should be directed toward comparative-effectiveness of simulation versus other accepted teaching methods, exploring the combination of procedural training with realistic clinical scenarios, and the application of simulation-based teaching curricula to a wider range of learner, from the student to the practicing physician.Keywords: regional anesthesia, simulation, medical education, ultrasound, nerve block, simulator

  7. A Study of MAC Protocols for WBANs

    Directory of Open Access Journals (Sweden)

    Sana Ullah

    2009-12-01

    Full Text Available The seamless integration of low-power, miniaturised, invasive/non-invasive lightweight sensor nodes have contributed to the development of a proactive and unobtrusive Wireless Body Area Network (WBAN. A WBAN provides long-term health monitoring of a patient without any constraint on his/her normal dailylife activities. This monitoring requires the low-power operation of invasive/non-invasive sensor nodes. In other words, a power-efficient Medium Access Control (MAC protocol is required to satisfy the stringent WBAN requirements, including low-power consumption. In this paper, we first outline the WBAN requirements that are important for the design of a low-power MAC protocol. Then we study low-power MAC protocols proposed/investigated for a WBAN with emphasis on their strengths and weaknesses. We also review different power-efficient mechanisms for a WBAN. In addition, useful suggestions are given to help the MAC designers to develop a low-power MAC protocol that will satisfy the stringent requirements.

  8. A study of MAC protocols for WBANs.

    Science.gov (United States)

    Ullah, Sana; Shen, Bin; Islam, S M Riazul; Khan, Pervez; Saleem, Shahnaz; Kwak, Kyung Sup

    2010-01-01

    The seamless integration of low-power, miniaturised, invasive/non-invasive lightweight sensor nodes have contributed to the development of a proactive and unobtrusive Wireless Body Area Network (WBAN). A WBAN provides long-term health monitoring of a patient without any constraint on his/her normal dailylife activities. This monitoring requires the low-power operation of invasive/non-invasive sensor nodes. In other words, a power-efficient Medium Access Control (MAC) protocol is required to satisfy the stringent WBAN requirements, including low-power consumption. In this paper, we first outline the WBAN requirements that are important for the design of a low-power MAC protocol. Then we study low-power MAC protocols proposed/investigated for a WBAN with emphasis on their strengths and weaknesses. We also review different power-efficient mechanisms for a WBAN. In addition, useful suggestions are given to help the MAC designers to develop a low-power MAC protocol that will satisfy the stringent requirements. PMID:22315531

  9. Modeling the dynamical effects of anesthesia on brain circuits.

    Science.gov (United States)

    Ching, Shinung; Brown, Emery N

    2014-04-01

    General anesthesia is a neurophysiological state that consists of unconsciousness, amnesia, analgesia, and immobility along with maintenance of physiological stability. General anesthesia has been used in the United States for more than 167 years. Now, using systems neuroscience paradigms how anesthetics act in the brain and central nervous system to create the states of general anesthesia is being understood. Propofol is one of the most widely used and the most widely studied anesthetics. When administered for general anesthesia or sedation, the electroencephalogram (EEG) under propofol shows highly structured, rhythmic activity that is strongly associated with changes in the patient's level of arousal. These highly structured oscillations lend themselves readily to mathematical descriptions using dynamical systems models. We review recent model descriptions of the commonly observed EEG patterns associated with propofol: paradoxical excitation, strong frontal alpha oscillations, anteriorization and burst suppression. Our analysis suggests that propofol's actions at GABAergic networks in the cortex, thalamus and brainstem induce profound brain dynamics that are one of the likely mechanisms through which this anesthetic induces altered arousal states from sedation to unconsciousness. Because these dynamical effects are readily observed in the EEG, the mathematical descriptions of how propofol's EEG signatures relate to its mechanisms of action in neural circuits provide anesthesiologists with a neurophysiologically based approach to monitoring the brain states of patients receiving anesthesia care. PMID:24457211

  10. Non-invasive anesthesia for children undergoing proton radiation therapy

    International Nuclear Information System (INIS)

    Background: Proton therapy is a newer modality of radiotherapy during which anesthesiologists face specific challenges related to the setup and duration of treatment sessions. Purpose: Describe our anesthesia practice for children treated in a standalone proton therapy center, and report on complications encountered during anesthesia. Materials and methods: A retrospective review of anesthetic records for patients ⩽18 years of age treated with proton therapy at our institution between January 2006 and April 2013 was performed. Results: A total of 9328 anesthetics were administered to 340 children with a median age of 3.6 years (range, 0.4–14.2). The median daily anesthesia time was 47 min (range, 15–79). The average time between start of anesthesia to the start of radiotherapy was 7.2 min (range, 1–83 min). All patients received Total Intravenous Anesthesia (TIVA) with spontaneous ventilation, with 96.7% receiving supplemental oxygen by non-invasive methods. None required daily endotracheal intubation. Two episodes of bradycardia, and one episode each of; seizure, laryngospasm and bronchospasm were identified for a cumulative incidence of 0.05%. Conclusions: In this large series of children undergoing proton therapy at a freestanding center, TIVA without daily endotracheal intubation provided a safe, efficient, and less invasive option of anesthetic care

  11. Consciousness fluctuation during general anesthesia: a theoretical approach to anesthesia awareness and memory modulation.

    Science.gov (United States)

    Cascella, Marco; Schiavone, Vincenzo; Muzio, Maria Rosaria; Cuomo, Arturo

    2016-08-01

    With anesthesia awareness as a model of study we debate the both fascinating and dangerous phenomenon called consciousness fluctuation that takes place during surgical anesthesia. In accordance with current scientific knowledge this paradox is the consequence of our limits in both precise knowledge of anesthesia mechanisms and our inability to accurately assess the level of anesthesia with brain monitoring. We also focus on the relationships between memory and anesthesia, as well as the possibility of interfering with memory during general anesthesia. PMID:27046232

  12. Radiology for anesthesia and critical care

    International Nuclear Information System (INIS)

    This book contains 14 chapters. Some of the chapter titles are: Understanding the Image; Preoperative Evaluation; Adult Respiratory Distress Syndrome; The Abdomen; Special Imaging Modalities; Radiographic Anatomy and Pathology of the Child's Airway; and The Neonate in Distress: Pulmonary Etiologies

  13. Shared decision making after MacIntyre.

    Science.gov (United States)

    Tilburt, Jon

    2011-04-01

    This paper explores the practical consequences that Enlightenment ideals had on morality as it applies to clinical practice, using Alisdair MacIntyre's conceptualization and critique of the Enlightenment as its reference point. Taking the perspective of a practicing clinician, I critically examine the historical origins of ideas that made shared decision making (SDM) a necessary and ideal model of clinician-patient relationship. I then build on MacIntyre's critique of Enlightenment thought and examine its implications for conceptions of shared decision-making that use an Enlightenment justification, as well as examining contemporary threats to SDM that the Enlightenment made possible. I conclude by offering an alternative framing of SDM that fits with the clinician's duty to act on behalf of and along with patients but that avoids the tenuous Enlightenment assumptions that MacIntyre's work so vocally critiques. PMID:21378085

  14. MacBook Pro Portable Genius

    CERN Document Server

    Miser, Brad

    2011-01-01

    Tips and techniques for forward-thinking MacBook Pro users Now that you have a MacBook Pro, you need just one more accessory, your very own copy of MacBook Pro Portable Genius, Third Edition. This handy, compact book lets you in on a wealth of tips and tricks, so you get the very most out of Apple's very popular notebook. Discover the latest on the most recent release of iLife, get the skinny on the new Intel Core i7 and i5 processors in the Pro, see how to go wireless in a smart way, and much more. The book is easy to navigate, doesn't skimp on the essentials, and helps you save time and avoi

  15. Office 2011 for Mac All-in-One For Dummies

    CERN Document Server

    Bajaj, Geetesh

    2011-01-01

    Get up to speed on the revolutionary changes in Office for the MacThe 2011 version of the Microsoft Office productivity suite for the Mac sports major changes from what Mac users are accustomed to. This soup-to-nuts guide gets the Mac crowd up to date quickly and easily. Individual minibooks thoroughly cover the Project Gallery, Word, Excel, PowerPoint, Outlook (new for Mac), and the Project Center. You'll learn how the new Office integrates with the Windows version, how to use and customize the new Ribbon interface, and much more.Office for Mac is the most popular office productivity suite fo

  16. Propofol-Based Sedation Versus General Anesthesia for Endoscopic Submucosal Dissection.

    Science.gov (United States)

    Yurtlu, Derya Arslan; Aslan, Fatih; Ayvat, Pinar; Isik, Yasemin; Karakus, Nesli; Ünsal, Belkis; Kizilkaya, Mehmet

    2016-05-01

    The main objective of this study is to evaluate general anesthesia or propofol-based sedation methods at gastric endoscopic submucosal dissection (ESD) procedures.The anesthetic method administered to cases undergoing upper gastrointestinal ESD between 2013 and 2015 was retrospectively investigated. Procedure time, lesion size, dissection speed, anesthesia time, adverse effects such as gag reflex, nausea, vomiting, cough, number of desaturation episodes (SpO2 fentanyl were significantly higher (P < 0.05). Anesthesia time, postoperative anesthesia care unit, and hospital stay durations were not significantly different between the groups.General anesthesia increased dissection speed and enhanced endoscopist performance when compared with propofol-based sedation technique. PMID:27196474

  17. Teach yourself visually MacBook

    CERN Document Server

    Miser, Brad

    2008-01-01

    If you prefer instructions that show you how to do something and skip the long-winded explanations, then this book is for you. You?ll find clear, step-by-step screen shots that show you how to tackle more than 160 MacBook tasks. Each task-based spread includes easy, visual directions for performing necessary operations, including using the Dock and Dashboard, managing Expos? and Spaces, video chatting with iChat, and creating albums and photos in iPhoto. Full-color screen shots demonstrate each task so that you can get started using your MacBook today.

  18. Variable TDMA MAC Protocol For WDM EPON

    Institute of Scientific and Technical Information of China (English)

    Minsuk Jung; Yongseok Chang; Jonghoon Eom; Sungho Kim

    2003-01-01

    A MAC(Media Access Control) protocol, one of the most important technologies for an EPON(Ethernet Passive Optical Network), contains a scheduling algorithm to avoid collisions in shared links and assigns an effective bandwidth when ONUs (Optical Network Units) transfer signals upward. The current paper proposes a MAC Protocol that operates a TDMA(Time method with a variable slot assignment to overcome short of bandwidth using by the number of n wavelength., the next generation access network. To verify the above, the current study also implements an EPON model using OPNET as the simulation tool.

  19. Mac OS X Snow Leopard pocket guide

    CERN Document Server

    Seiblod, Chris

    2009-01-01

    Whether you're new to the Mac or a longtime user, this handy book is the quickest way to get up to speed on Snow Leopard. Packed with concise information in an easy-to-read format, Mac OS X Snow Leopard Pocket Guide covers what you need to know and is an ideal resource for problem-solving on the fly. This book goes right to the heart of Snow Leopard, with details on system preferences, built-in applications, and utilities. You'll also find configuration tips, keyboard shortcuts, guides for troubleshooting, lots of step-by-step instructions, and more. Learn about new features and changes s

  20. Problematising Practice: MacIntyre and Management

    OpenAIRE

    Kavanagh, Donncha

    2013-01-01

    Alasdair MacIntyre's distinction between institutions and practices helps illuminate how powerful institutional forces frame and constrain the practice of organizational research as well as the output and positioning of scholarly journals like Organization.  Yet his conceptual frame is limited, not least because it is unclear whether the activity of managing is, or is not, a practice.  This paper builds on MacIntyre's ideas by incorporating Aristotle's concepts of poíēsis, praxis, téchnē and ...

  1. MacBook Pro Portable Genius

    CERN Document Server

    Miser, Brad

    2012-01-01

    Discover loads of tips and techniques for the newest MacBook Pro You're already ahead of the game with a MacBook Pro. Now you can get even more out the popular Apple notebook with the new edition of this handy, compact book. Crammed with savvy insights and tips on key tools and shortcuts, this book will help you increase your productivity and keep your Apple digital lifestyle on track. From desktop sharing and wireless networking to running Windows applications, this book avoids fluff, doesn't skimp on the essentials, saves you time and hassle, and shows you what you most want to know. Include

  2. The MacNew Heart Disease health-related quality of life instrument: A summary

    Directory of Open Access Journals (Sweden)

    Guyatt Gordon

    2004-01-01

    Full Text Available Abstract Background The measurement of health, the effects of disease, and the impact of health care include not only an indication of changes in disease frequency and severity but also an estimate of patients' perception of health status before and after treatment. One of the more important developments in health care in the past decade may be the recognition that the patient's perspective is as legitimate and valid as the clinician's in monitoring health care outcomes. This has lead to the development of instruments to quantify the patients' perception of their health status before and after treatment. Methods We review evidence supporting the measurement properties of the MacNew Heart Disease Health-related Quality of Life [MacNew] Questionnaire which was designed to evaluate how daily activities and physical, emotional, and social functioning are affected by coronary heart disease and its treatment. Results Reliability was demonstrated by using internal consistency and the intraclass correlation coefficients for the three domains in the Dutch, English, Farsi, German, and Spanish versions of the MacNew. With internal consistency and intraclass correlation coefficients =>0.73, reliability is high. Validity of the MacNew was examined with factor analysis and three core underlying factors, physical, emotional, and social, were identified, explaining 63.0 – 66.5% of the observed variance and replicated in the translations with psychometric data. Construct validity of the MacNew was further demonstrated by extensive substantiation of the logical relationships, defined a priori, between items and other comparison tools. The MacNew is responsive and sensitive to changes in HRQL following various interventions for patients with heart disease with 11 of 13 effect size statistics >0.80. Taking an average of 10 minutes or less to complete, the respondent-burden for the MacNew is low and its acceptability is demonstrated by response rates of over 90

  3. The Ryder Cognitive Aid Checklist for Trauma Anesthesia.

    Science.gov (United States)

    Behrens, Vicente; Dudaryk, Roman; Nedeff, Nicholas; Tobin, Joshua M; Varon, Albert J

    2016-05-01

    Despite mixed results regarding the clinical utility of checklists, the anesthesia community is increasingly interested in advancing research around this important topic. Although several checklists have been developed to address routine perioperative care, few checklists in the anesthesia literature specifically target the management of trauma patients. We adapted a recently published "trauma and emergency checklist" for the initial phase of resuscitation and anesthesia of critically ill trauma patients into an applicable perioperative cognitive aid in the form of a pictogram that can be downloaded by the medical community. The Ryder Cognitive Aid Checklist for Trauma Anesthesia is a letter-sized, full-color document consisting of 2 pages and 5 sections. This cognitive aid describes the essential steps to be performed: before patient arrival to the hospital, on patient arrival to the hospital, during the initial assessment and management, during the resuscitation phase, and for postoperative care. A brief online survey is also presented to obtain feedback for improvement of this tool. The variability in utility of cognitive aids may be because of the specific clinical task being performed, the skill level of the individuals using the cognitive aid, overall quality of the cognitive aid, or organizational challenges. Once optimized, future research should be focused at ensuring successful implementation and customization of this tool. PMID:27101496

  4. Anesthesia for off-pump coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Thomas M Hemmerling

    2013-01-01

    Full Text Available The evolution of techniques and knowledge of beating heart surgery has led anesthesia toward the development of new procedures and innovations to promote patient safety and ensure high standards of care. Off-pump coronary artery bypass (OPCAB surgery has shown to have some advantages compared to on-pump cardiac surgery, particularly the reduction of postoperative complications including systemic inflammation, myocardial injury, and cerebral injury. Minimally invasive surgery for single vessel OPCAB through a limited thoracotomy incision can offer the advantage of further reduction of complications. The anesthesiologist has to deal with different issues, including hemodynamic instability and myocardial ischemia during aorto-coronary bypass grafting. The anesthesiologist and surgeon should collaborate and plan the best perioperative strategy to provide optimal care and ensure a rapid and complete recovery. The use of high thoracic epidural analgesia and fast-track anesthesia offers particular benefits in beating heart surgery. The excellent analgesia, the ability to reduce myocardial oxygen consumption, and the good hemodynamic stability make high thoracic epidural analgesia an interesting technique. New scenarios are entering in cardiac anesthesia: ultra-fast-track anesthesia with extubation in the operating room and awake surgery tend to be less invasive, but can only be performed on selected patients.

  5. Reactive Software Agent Anesthesia Decision Support System

    Directory of Open Access Journals (Sweden)

    Grant H. Kruger

    2011-12-01

    Full Text Available Information overload of the anesthesiologist through technological advances have threatened the safety of patients under anesthesia in the operating room (OR. Traditional monitoring and alarm systems provide independent, spatially distributed indices of patient physiological state. This creates the potential to distract caregivers from direct patient care tasks. To address this situation, a novel reactive agent decision support system with graphical human machine interface was developed. The system integrates the disparate data sources available in the operating room, passes the data though a decision matrix comprising a deterministic physiologic rule base established through medical research. Patient care is improved by effecting change to the care environment by displaying risk factors and alerts as an intuitive color coded animation. The system presents a unified, contextually appropriate snapshot of the patient state including current and potential risk factors, and alerts of critical patient events to the operating room team without requiring any user intervention. To validate the efficacy of the system, a retrospective analysis focusing on the hypotension rules were performed. Results show that even with vigilant and highly trained clinicians, deviations from ideal patient care exist and it is here that the proposed system may allow more standardized and improved patient care and potentially outcomes.

  6. The Big Mac Standard: A statistical Illustration

    OpenAIRE

    Yukinobu Kitamura; Hiroshi Fujiki

    2004-01-01

    We demonstrate a statistical procedure for selecting the most suitable empirical model to test an economic theory, using the example of the test for purchasing power parity based on the Big Mac Index. Our results show that supporting evidence for purchasing power parity, conditional on the Balassa-Samuelson effect, depends crucially on the selection of models, sample periods and economies used for estimations.

  7. Diagnosing & Treating Digestive Tract Disorders Endoscopically

    Medline Plus

    Full Text Available ... of our procedures with the support of our anesthesia providers, either under general anesthesia or under what we call MAC, which is monitored anesthesia care. And that allows us to do a ...

  8. Exposure histories of lunar meteorites - ALHA81005, MAC88104, MAC88105, and Y791197

    Science.gov (United States)

    Nishiizumi, K.; Arnold, J. R.; Klein, J.; Fink, D.; Middleton, R.; Kubik, P. W.; Sharma, P.; Elmore, D.; Reedy, R. C.

    1991-01-01

    The cosmogenic radionuclides Ca-41, Cl-36, Al-26, and Be-10 in the Allan Hills 81005, MacAlpine Hills 88104, MacAlpine Hills 88105, and Yamato 791197 meteorites were measured by accelerator mass spectrometry. Mn-53 in Allan Hills 81005 and Yamato 791197 was measured by neutron activation. These four lunar meteorites experienced similar histories. They were ejected from near the surface of the moon ranging in depth down to 400 g/sq cm and had very short transition times (less than 0.1 Ma) from the moon to the earth. A comparison of the cosmogenic nuclide concentrations in MacAlpine Hills 88104 and MacAlpine Hills 88105 clearly indicates that they are a pair from the same fall.

  9. Marsupial, insectivore, and chiropteran anesthesia.

    Science.gov (United States)

    Pye, G W

    2001-01-01

    This article covers the manual restraint and anesthesia of marsupials, insectivores, and chiroptera. Marsupials commonly kept as pets in the U.S. [e.g., eastern gray kangaroos (Macropus giganteus), Bennett's wallabies (Macropus rufogriseus), and sugar gliders (Petaurus breviceps)] are covered in detail. Marsupial species kept in zoological parks [e.g., Tasmanian devils, koalas (Phascolarctos cinereus), and common wombats (Vombatus ursinus)] are covered in less detail. Of the insectivores, only the African hedgehog (Atelerix albiventris) and the European hedgehog (Erinaceus europaeus) are commonly kept as pets and, consequently, the insectivore section concentrates on discussing these two species. The section on chiropteran anesthesia is divided into two broad categories: the megachiropterans (flying foxes and fruit bats) and the microchiropterans (insectivorous bats). Most of the information on the species covered in this article is anecdotal, and this should be kept in mind when using the anesthesia protocols described. PMID:11217462

  10. Stabilizing membrane domains antagonizes anesthesia

    CERN Document Server

    Machta, Benjamin B; Nouri, Mariam; McCarthy, Nicola L C; Gray, Erin M; Miller, Ann L; Brooks, Nicholas J; Veatch, Sarah L

    2016-01-01

    Diverse molecules induce general anesthesia with potency strongly correlated both with their hydrophobicity and their effects on certain ion channels. We recently observed that several anesthetics inhibit heterogeneity in plasma membrane derived vesicles by lowering the critical temperature ($T_c$) for phase separation. Here we exploit conditions that stabilize membrane heterogeneity to test the correlation between the anesthetic potency of n-alcohols and effects on $T_c$. First we show that hexadecanol acts oppositely to anesthetics on membrane mixing and antagonizes ethanol induced anesthesia in a tadpole behavioral assay. Second, we show that two previously described `intoxication reversers' raise $T_c$ in vesicles and counter ethanol's effects in vesicles, mimicking the findings of previous electrophysiological measurements. Third, we find that hydrostatic pressure, long known to reverse anesthesia, also raises $T_c$ in vesicles with a magnitude that counters the effect of an anesthetic at relevant concen...

  11. Anesthesia for Children Having Eye Surgery

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Anesthesia for Children Having Eye Surgery En Español Read in Chinese What kinds of anesthesia are available for children having eye surgery? There ...

  12. Anesthesia for Adults Having Eye Surgery

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Anesthesia for Adults Having Eye Surgery En Español What kinds of anesthesia are available for adults having eye surgery? A “ ...

  13. Anesthesia Safe for Infants, Toddlers, Study Says

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/news/fullstory_159247.html Anesthesia Safe for Infants, Toddlers, Study Says No lingering ... 2016 TUESDAY, June 7, 2016 (HealthDay News) -- General anesthesia doesn't seem to harm young children's mental ...

  14. Back Pain and Neuraxial Anesthesia.

    Science.gov (United States)

    Benzon, Honorio T; Asher, Yogen G; Hartrick, Craig T

    2016-06-01

    The incidence of back pain after neuraxial anesthesia in the adult population is not different from that after general anesthesia. The pain is usually mild, localized in the low back, rarely radiates to the lower extremities, and has a duration of only a few days. The risk factors for development of back pain include the lithotomy position, multiple attempts at block placement, duration of surgery longer than 2.5 hours, body mass index ≥32 kg/m, and a history of back pain. However, there is no permanent worsening of preexisting back pain after neuraxial anesthesia. The back pain has been attributed to tears in the ligaments, fascia, or bone with localized bleeding; immobility of the spine; relaxation of the paraspinal muscles under anesthesia; flattening of the normal lumbar convexity; and stretching and straining of the lumbosacral ligaments and joint capsules. The addition of an anti-inflammatory drug to the local anesthetic used for skin infiltration may decrease the incidence and severity of back pain. The use of spinal or epidural anesthesia in the adult, non-obstetric and obstetric populations should depend on the advantages offered by the technique and not on the occurrence of back pain after the procedure. Additional studies are needed to confirm the efficacy of epidural dexamethasone, or other steroids, or the addition of an anti-inflammatory drug to the local anesthetic infiltration for the prevention of back pain after neuraxial anesthesia. Future studies should involve a physician with expertise in the evaluation of chronic low back pain to help identify the cause of the back pain and institute appropriate treatment(s). PMID:27195644

  15. CR-MAC: A Multichannel MAC Protocol for Cognitive Radio AD HOC Networks

    Directory of Open Access Journals (Sweden)

    S. M. Kamruzzaman

    2010-09-01

    Full Text Available This paper proposes a cross-layer based cognitive radio multichannel medium access control (MACprotocol with TDMA, which integrate the spectrum sensing at physical (PHY layer and the packetscheduling at MAC layer, for the ad hoc wireless networks. The IEEE 802.11 standard allows for the useof multiple channels available at the PHY layer, but its MAC protocol is designed only for a singlechannel. A single channel MAC protocol does not work well in a multichannel environment, because ofthe multichannel hidden terminal problem. Our proposed protocol enables secondary users (SUs toutilize multiple channels by switching channels dynamically, thus increasing network throughput. In ourproposed protocol, each SU is equipped with only one spectrum agile transceiver, but solves themultichannel hidden terminal problem using temporal synchronization. The proposed cognitive radioMAC (CR-MAC protocol allows SUs to identify and use the unused frequency spectrum in a way thatconstrains the level of interference to the primary users (PUs. Our scheme improves network throughputsignificantly, especially when the network is highly congested. The simulation results show that ourproposed CR-MAC protocol successfully exploits multiple channels and significantly improves networkperformance by using the licensed spectrum band opportunistically and protects PUs from interference,even in hidden terminal situations.

  16. The comparison of spinal anesthesia with general anesthesia on the postoperative pain scores and analgesic requirements after elective lower abdominal surgery: A randomized, double-blinded study

    Directory of Open Access Journals (Sweden)

    Khosrou Naghibi

    2013-01-01

    Full Text Available Background: The aim of this study was to compare the postoperative pain scores and morphine requirements between spinal anesthesia (SA with hyperbaric bupivacaine 0.5% and general anesthesia (GA with 1 Minimal alveolar concentration minimal alveolar concentration (MAC of isoflurane in 50% N 2 O and O 2 after elective lower abdominal surgery. Materials and Methods: In this randomized clinical trial, 68 patients with American Society of Anesthesiologists (ASA I or II undergoing lower abdominal surgery were randomly assigned to have elective lower abdominal surgery under SA (n = 34 or GA (n = 34. The SA group received 3 cc of 0.5% hyperbaric bupivacaine (15 mg, at L3-L4 interspace intrathecally and also 2 mic/kg fentanyl and 0.15 mg/kg morphine intravenously for intraoperative analgesia. In the GA group, induction of anesthesia was carried out with Na thiopental 6 mg/kg body weight, fentanyl 2 mic/kg body weight, morphine 0.15 mg/kg, and atracurium 0.6 mg/kg body weight, and then, trachea was intubated. The primary outcome was postoperative pain scores at rest and under stress on a visual analog scale and the secondary outcome was morphine requirement by the patients. Outcome measures were recorded at 2, 4, 6, 12, and 24 h postoperatively. The duration of postanesthesia care unit (PACU and hospital stay were recorded. Intraoperative parameters, postoperative pain scores, complications, recovery time, and the duration of hospital stay at follow up were compared between the two groups. Results: Patients in SA group had significantly lower scores of a postoperative pain at rest (3.4 ± 1.6 and 4.1 ± 1.2 at 2 and 4 h postoperatively vs. 5.2 ± 1.5 and 5.8 ± 0.9 in the GA group with P < 0.05, but there were no significant differences between both groups for scores of postoperative pain at 6, 12, and 24 h. The amount of morphine requirement in 6 h postoperatively was significantly lower in the SA group (10.2 ± 4.3 mg vs. 15.6 ± 5.6 mg in the GA group

  17. The thermodynamics of general anesthesia

    CERN Document Server

    Heimburg, T; Heimburg, Thomas; Jackson, Andrew D.

    2006-01-01

    It is known that the action of general anesthetics is proportional to their partition coefficient in lipid membranes (Meyer-Overton rule). This solubility is, however, directly related to the depression of the temperature of the melting transition found close to body temperature in biomembranes. We propose a thermodynamic extension of the Meyer-Overton rule which is based on free energy changes in the system and thus automatically incorporates the effects of melting point depression. This model provides a quantitative explanation of the pressure reversal of anesthesia. Further, it explains why inflammation and the addition of divalent cations reduce the effectiveness of anesthesia.

  18. Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH - General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial

    DEFF Research Database (Denmark)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels;

    2016-01-01

    RATIONALE: Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes...... compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. AIM AND HYPOTHESIS: The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether...... study. Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. STUDY OUTCOMES: The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging...

  19. Anesthesia management in a pediatric patient with Dandy-Walker syndrome

    OpenAIRE

    Zeynep Baysal Yıldırım; Salim Akdemir; Vildan Temel; Adnan Tüfek; Feyzi Çelik; Gönül Ölmez Kavak

    2011-01-01

    General anesthesia management of patients with Dandy-Walker syndrome is important since intubation may be difficult due to concomitant anomalies such as hydrocephalus, micrognathia and cleft palate. It should be considered that these patients may require postoperative intensive care support. In this article, anesthesia management of a patient with Dandy-Walker syndrome underwent persistent ventriculo-peritoneal shunt was presented. J Clin Exp Invest 2011; 2 (3): 327-329.

  20. A revisit of transthecal digital block and traditional digital block for anesthesia of the finger

    OpenAIRE

    Mohammad Dehghani; Arsalan Mahmoodian

    2007-01-01

    BACKGROUND: Finger injuries are very common and the majority can be treated under digital block anesthesia. Traditional digital block is one of the most commonly performed blocks by care providers in several medical fields. There is another less known method, transthecal (Pulley) block, in which local anesthesia is injected into the flexor tendon sheath.
    METHODS: A randomized clinical trial was performed to compare the tran...

  1. 21 CFR 868.6700 - Anesthesia stool.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia stool. 868.6700 Section 868.6700 Food... DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6700 Anesthesia stool. (a) Identification. An anesthesia stool is a device intended for use as a stool for the anesthesiologist in the operating room....

  2. Isolation and characterisation of human gingival margin-derived STRO-1/MACS1 and MACS2 cell populations

    Institute of Scientific and Technical Information of China (English)

    Karim M Fawzy El-Sayed; Sebastian Paris; Christian Graetz; Neemat Kassem; Mohamed Mekhemar; Hendrick Ungefroren; Fred Fandrich; Christof Dorfer

    2015-01-01

    Recently, gingival margin-derived stem/progenitor cells isolated via STRO-1/magnetic activated cell sorting (MACS) showed remarkable periodontal regenerative potential in vivo. As a second-stage investigation, the present study’s aim was to perform in vitro characterisation and comparison of the stem/progenitor cell characteristics of sorted STRO-1-positive (MACS1) and STRO-1-negative (MACS2) cell populations from the human free gingival margin. Cells were isolated from the free gingiva using a minimally invasive technique and were magnetically sorted using anti-STRO-1 antibodies. Subsequently, the MACS1 and MACS2 cell fractions were characterized by flow cytometry for expression of CD14, CD34, CD45, CD73, CD90, CD105, CD146/MUC18 and STRO-1. Colony-forming unit (CFU) and multilineage differentiation potential were assayed for both cell fractions. Mineralisation marker expression was examined using real-time polymerase chain reaction (PCR). MACS1 and MACS2 cell fractions showed plastic adherence. MACS1 cells, in contrast to MACS2 cells, showed all of the predefined mesenchymal stem/progenitor cell characteristics and a significantly higher number of CFUs (P,0.01). More than 95%of MACS1 cells expressed CD105, CD90 and CD73;lacked the haematopoietic markers CD45, CD34 and CD14, and expressed STRO-1 and CD146/MUC18. MACS2 cells showed a different surface marker expression profile, with almost no expression of CD14 or STRO-1, and more than 95%of these cells expressed CD73, CD90 and CD146/MUC18, as well as the haematopoietic markers CD34 and CD45 and CD105. MACS1 cells could be differentiated along osteoblastic, adipocytic and chondroblastic lineages. In contrast, MACS2 cells demonstrated slight osteogenic potential. Unstimulated MACS1 cells showed significantly higher expression of collagen I (P,0.05) and collagen III (P,0.01), whereas MACS2 cells demonstrated higher expression of osteonectin (P,0.05;Mann–Whitney). The present study is the first to compare gingival

  3. MacBook All-in-One For Dummies

    CERN Document Server

    Chambers, Mark L

    2011-01-01

    Get comfortable and confident with your MacBook! Combining the fun-but-straightforward content of nine minibooks, this new edition of MacBook All-in-One For Dummies delivers helpful coverage of the rich features and essential tools you need to know to use the MacBook to its fullest potential. You'll learn an array of MacBook basics while veteran author Mark Chambers walks you through setting up your MacBook, running programs, finding files with Finder, searching with Spotlight, keeping track with Address Book, enjoying music with iTunes, creating cool multimedia projects with iLife, and more.

  4. Anesthesia and the developing brain

    DEFF Research Database (Denmark)

    Davidson, Andrew J; Becke, Karin; de Graaff, Jurgen;

    2015-01-01

    It is now well established that many general anesthetics have a variety of effects on the developing brain in animal models. In contrast, human cohort studies show mixed evidence for any association between neurobehavioural outcome and anesthesia exposure in early childhood. In spite of large...

  5. Periocular Anesthesia in Aesthetic Surgery

    OpenAIRE

    Skibell, Bentley C.; Soparkar, Charles N.S.; Tower, Robert N.; Patrinely, James R.

    2007-01-01

    This article focuses on the administration of anesthesia for periocular aesthetic procedures. Special emphasis is given to office-based procedures, most often without any systemic sedation, highlighting the importance of open communication with patients. Finally, attention is given to potential pitfalls including anesthetic systemic toxicity, ocular injuries, and orbicularis myotoxicity.

  6. History of anesthesia in Germany.

    Science.gov (United States)

    Wawersik, J

    1991-01-01

    The first ether anesthetic was administered in Germany by J.F. Heyfelder (1798-1869) at the Erlangen University Hospital on January 24, 1847. Thereafter, famous discoveries occurred in the field of pharmacology. Albert Niemann isolated cocaine from the coca shrub in 1860; Emil Fischer synthesized the first barbiturate, Veronal, in 1902; and Helmut Weese promoted the first ultra-short-acting barbiturate, hexobarbital (Evipan), in 1932. The local anesthetic effect of cocaine was reported by Koller at the Congress of the German Society for Ophthalmology on September 15, 1884, in Heidelberg. Many new techniques were tried first in German hospitals. Friedrich Trendelenburg carried out, by tracheotomy, the first operation with endotracheal intubation in 1869, and Franz Kuhn promoted and clinically practiced endotracheal intubation in Heidelberg beginning in 1900. August Bier performed the first operation under spinal anesthesia at the Kiel University Hospital on August 16, 1898. Carl Ludwig Schleich (1859-1922) standardized the methods of infiltration anesthesia by using a cocaine solution in sufficient dilution. The development of anesthesia machines was greatly influenced by Heinrich Dräger (1847-1917) and his son Bernhard Dräger (1870-1928). The Dräger Company in Lübeck built the first anesthesia machine with a carbon dioxide (CO2) absorber and circle system in 1925. Paul Sudeck and Helmut Schmidt worked with this system at the Hamburg University Hospital and reported their results in 1926. The first Dräger anesthesia machine was produced in 1902 and introduced into clinical use by Otto Roth (1863-1944) in Lübeck. Before the Second World War, three universities in Germany carried out research in the field of anesthesia: the University of Freiburg with H. Killian, the University of Hamburg with P. Sudeck and H. Schmidt, and the University of Würzburg with C.G. Gauss. Killian and Gauss established the first journals, Der Schmerz and Narkose und Anaesthesie, in

  7. Improved b lifetime measurement from MAC

    International Nuclear Information System (INIS)

    Two recent publications, from the MAC and Mark II collaborations, have reported the somewhat surprising result that the lifetime of particles made up of b quarks is in the 1 to 2 picosecond range, or somewhat longer than the lifetimes of charm particles. Although the charm decays are favored transitions while those of b particles depend upon off-diagonal elements of the weak flavor mixing matrix, the smallness of the b decay rates in face of the large available phase space indicates that the off-diagonal elements are indeed very small. The possibility for complete determination of the mixing matrix was brought significantly nearer by the availability of the lifetime information; what is needed now is to reduce the uncertainty of the measurements, which was about 33% for both experiments. We describe here an extension of the b lifetime study with the MAC detector, incorporating some new data and improvements in the analysis. 12 references

  8. Improved b lifetime measurement from MAC

    International Nuclear Information System (INIS)

    Two recent publications, from the MAC and Mark II collaborations, have reported the somewhat surprising result that the lifetime of particles made up of b quarks is in the 1 to 2 picosecond range, or somewhat longer than the lifetimes of charm particles. Although the charm decays are favored transitions while those of b particles depend upon off-diagonal elements of the weak flavor mixing matrix, the smallness of the b decay rates in face of the large available phase space indicates that the off-diagonal elements are indeed very small. The possibility for complete determination of the mixing matrix was brought significantly nearer by the availability of the lifetime information; what is needed now is to reduce the uncertainty of the measurements, which was about 33% for both experiments. We describe here an extension of the b lifetime study with the MAC detector, incorporating some new data and improvements in the analysis

  9. MacBook Pro portable genius

    CERN Document Server

    Gruman, Galen

    2013-01-01

    Learn the skills, tools and shortcuts you need in order to make the most of your MacBook Pro This easy-to-use, compact guide skips the fluff and gets right to the essentials so that you can maximize all the latest features of the MacBook Pro. Packed with savvy insights and tips on key tools and shortcuts, this handy book aims to help you increase your productivity and save you time and hassle. From desktop sharing and wireless networking to running Windows applications and more, this book shows you what you want to know. Includes the latest version of OS X, iCloud, FaceTime, and moreCovers al

  10. Appropriate practice of anesthesia: A plea for better training

    Directory of Open Access Journals (Sweden)

    O P Adudu

    2011-01-01

    Full Text Available Background: The role of the anesthesiologist is often unknown among patients. But, the situation where the anesthesiologist is uncertain of his/her function gives more cause for concern. Methods: A questionnaire survey on the appraisal of anesthetic practices was carried out over 5 months using the style of clinical practice. Results: One-third of the anesthesiologists who responded to the survey attached little importance to the work they did by not communicating the same to their patients while 45.2% did not discuss the intraoperative findings with the surgeons. Although 57 (59.4% of the respondents usually visit their patients on the ward preoperatively, only 16 (21.6% discussed the proposed anesthetic procedure with the patients. Thirty-nine (40.2% respondents claimed that they do not wear ward coats to the ward at the preoperative visit. Less than 20% consistently conducted a postoperative visit. The majority of the respondents would treat all patients as important, irrespective of social status, while 74.5% of them considered obtaining informed consent for anesthesia from patients as significantly important. Conclusion: The current practice of anesthesia has been found wanting in several aspects. Knowledgeable discussion by anesthesiologists with surgeons as well as enlightenment of patients and their relatives about their work will improve the quality of anesthesia care remarkably. Changes in the anesthesia training curriculum to reflect these deficiencies would be helpful.

  11. MAC Design for Optical Wireless Communications

    OpenAIRE

    Li, Yiyang

    2011-01-01

    This thesis mainly focuses on the higher layer protocol design for optical wireless communication (OWC) networks in two different optical bands: (1) medium access control (MAC) protocol design and neighbor discovery methods for deep ultraviolet (UV) outdoor communications (UVOC), and (2) configuration of indoor visible light communication (VLC) networks. For UVOC, solar blind and non-line-of-sight (NLOS) operations are attractive. Light beams from UV light-emitting diode (LED) arrays propagat...

  12. A Study of MAC Protocols for WBANs

    OpenAIRE

    Sana Ullah; Bin Shen; S. M. Riazul Islam; Pervez Khan; Shahnaz Saleem; Kyung Sup Kwak

    2009-01-01

    The seamless integration of low-power, miniaturised, invasive/non-invasive lightweight sensor nodes have contributed to the development of a proactive and unobtrusive Wireless Body Area Network (WBAN). A WBAN provides long-term health monitoring of a patient without any constraint on his/her normal dailylife activities. This monitoring requires the low-power operation of invasive/non-invasive sensor nodes. In other words, a power-efficient Medium Access Control (MAC) protocol is required to s...

  13. Power Saving MAC Protocols for WSNs and Optimization of S-MAC Protocol

    Directory of Open Access Journals (Sweden)

    Simarpreet Kaur

    2012-11-01

    Full Text Available Low power MAC protocols have received a lot of consideration in the last few years because of their influence on the lifetime of wireless sensor networks. Since, sensors typically operate on batteries, replacement of which is often difficult. A lot of work has been done to minimize the energy expenditure and prolong the sensor lifetime through energy efficient designs, across layers. Meanwhile, the sensor network should be able to maintain a certain throughput in order to fulfill the QoS requirements of the end user, and to ensure the constancy of the network. This paper introduces different types of MAC protocols used for WSNs and proposes S‐MAC, a Medium‐Access Control protocol designed for Wireless Sensor Networks. S‐MAC uses a few innovative techniques to reduce energy consumption and support selfconfiguration. A new protocol is suggested to improve the energy efficiency, latency and throughput of existing MAC protocol for WSNs. A modification of the protocol is then proposed to eliminate the need for some nodes to stay awake longer than the other nodes which improves the energy efficiency, latency and throughput and hence increases the life span of a wireless sensor network.

  14. PERI-ANESTHESIA ANAPHYLAXIS (PAA): WE STILL HAVE NOT STARTED POST-PAA TESTING FOR INCITING ANESTHESIA-RELATED ALLERGENS.

    Science.gov (United States)

    Alshaeri, Taghreed; Gupta, Deepak; Nagabhushana, Ananthamurthy

    2016-02-01

    Anaphylaxis during anesthesia is uncommon. Diagnosis of peri-anesthesia anaphylaxis (PAA) requires anesthesia providers' vigilance for prompt diagnosis and treatment. In this case report, we present a challenging case with suspected PAA including its perioperative management, intensive care unit (ICU) course, and post-discharge follow-up. A 44-year-old female (body mass index = 26) presented for elective abdominal panniculectomy. Post-intubation, severe bronchospasm occurred that was non-responsive to nebulized albuterol and intravenous epinephrine. Continuous infusion of epinephrine was initiated. After aborting surgical procedure, the patient was transferred to ICU on continuous intravenous infusion of epinephrine. Venous blood sampling showed elevated troponin level. Echocardiography revealed ejection fraction of 25% suspicious of Takotsubo cardiomyopathy (mid cavitary variant). Tracheal extubation was only possible after three days. Subsequently, patient was discharged home with a cardiology follow-up appointment and a referral to an allergy specialist. Unfortunately at our institution (an academic university hospital in United States) along with neighboring institutions in near-by areas, the only allergy skin tests available are for local anesthetics and antibiotics, while neuromuscular blocking agents (NMBAs) cannot be tested (the suspected anaphylactic agent in our case was presumably rocuronium). In summary, PAA requires and responds to emergent diagnosis and immediate treatment; however there is still a long way to go to ensure post-PAA testing for inciting anesthesia-related allergens. PMID:27382817

  15. W-MAC: A Workload-Aware MAC Protocol for Heterogeneous Convergecast in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Dongming Lu

    2011-02-01

    Full Text Available The power consumption and latency of existing MAC protocols for wireless sensor networks (WSNs are high in heterogeneous convergecast, where each sensor node generates different amounts of data in one convergecast operation. To solve this problem, we present W-MAC, a workload-aware MAC protocol for heterogeneous convergecast in WSNs. A subtree-based iterative cascading scheduling mechanism and a workload-aware time slice allocation mechanism are proposed to minimize the power consumption of nodes, while offering a low data latency. In addition, an efficient schedule adjustment mechanism is provided for adapting to data traffic variation and network topology change. Analytical and simulation results show that the proposed protocol provides a significant energy saving and latency reduction in heterogeneous convergecast, and can effectively support data aggregation to further improve the performance.

  16. Ambulatory surgery with chloroprocaine spinal anesthesia: a review

    Directory of Open Access Journals (Sweden)

    Ghisi D

    2015-11-01

    Full Text Available Daniela Ghisi, Stefano Bonarelli Department of Anaesthesia and Postoperative Intensive Care, Istituto Ortopedico Rizzoli, Bologna, Italy Abstract: Spinal anesthesia is a reliable and safe technique for procedures of the lower extremities. Nevertheless, some of its characteristics may limit its use for ambulatory surgery, including delayed ambulation, risk of urinary retention, and pain after block regression. The current availability of short-acting local anesthetics has renewed interest for this technique also in the context of short- and ultra-short procedures. Chloroprocaine (CP is an amino-ester local anesthetic with a very short half-life. It was introduced and has been successfully used for spinal anesthesia since 1952. Sodium bisulfite was then added as a preservative after 1956. The drug was then abandoned in the 1980s for several reports of neurological deficits in patients receiving accidentally high doses of intrathecal CP during epidural labor analgesia. Animal studies have proven the safety of the preservative-free formulation, which has been extensively evaluated in volunteer studies as well as in clinical practice with a favorable profile in terms of both safety and efficacy. In comparison with bupivacaine, 2-chloroprocaine (2-CP showed faster offset times to end of anesthesia, unassisted ambulation, and discharge from hospital. These findings suggests that 2-CP may be a suitable alternative to low doses of long-acting local anesthetics in ambulatory surgery. Its safety profile also suggests that 2-CP could be a valid substitute for intrathecal short- and intermediate-acting local anesthetics, such as lidocaine and mepivacaine – often causes of transient neurological symptoms. In this context, literature suggests a dose ranging between 30 and 60 mg of 2-CP for procedures lasting 60 minutes or less, while 10 mg is considered the no-effect dose. The present review describes recent evidence about 2-CP as an anesthetic agent for

  17. MFT-MAC: A Duty-Cycle MAC Protocol Using Multiframe Transmission for Wireless Sensor Networks

    OpenAIRE

    EunJin Lee; Jeong Woo Jwa; HeungSoo Kim

    2013-01-01

    In many sensor network applications, energy efficiency and latency are major design criteria because battery-operated sensor nodes limit network lifetime. In this paper, we propose a new contention-based duty-cycle MAC protocol using a synchronized approach for use in wireless sensor networks. In the proposed MFT-MAC protocol, we use a control frame that considers the number of DATA frames to be transmitted to the next node in order to improve the energy efficiency and reduce the end-to-end d...

  18. Acupuncture in ambulatory anesthesia: a review

    Directory of Open Access Journals (Sweden)

    Norheim AJ

    2015-09-01

    Full Text Available Arne Johan Norheim,1 Ingrid Liodden,1 Terje Alræk1,2 1National Research Center in Complementary and Alternative Medicine (NAFKAM, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, 2The Norwegian School of Health Sciences, Institute of Acupuncture, Kristiania University College, Oslo, NorwayBackground: Post-anesthetic morbidities remain challenging in our daily practice of anesthesia. Meta-analyses and reviews of acupuncture and related techniques for postoperative nausea and vomiting (POVN and postoperative vomiting (POV show promising results while many clinicians remain skeptical of the value of acupuncture. Given the interest in finding safe non-pharmacological approaches toward postoperative care, this body of knowledge needs to be considered. This review critically appraises and summarizes the research on acupuncture and acupressure in ambulatory anesthesia during the last 15 years.Methods: Articles were identified through searches of Medline, PubMed, and Embase using the search terms “acupuncture” or “acupuncture therapy” in combination with “ambulatory anesthesia” or “ambulatory surgery” or “day surgery” or “postoperative”. A corresponding search was done using “acupressure” and “wristbands”. The searches generated a total of 104, 118, and 122 references, respectively.Results: Sixteen studies were included; eight studies reported on acupuncture and eight on acupressure. Nine studies found acupuncture or acupressure effective on primary endpoints including postoperative nausea and vomiting, postoperative pain, sore throat, and emergence agitation. Four studies found acupuncture had a similar effect to antiemetic medication.Conclusion: Overall, the studies were of fairly good quality. A large proportion of the reviewed papers highlights an effect of acupuncture or acupressure on postoperative morbidities in an ambulatory setting

  19. The elderly and general anesthesia

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2010-01-01

    Due to the aging population, the number of elderly patients taking advantage of healthcare services is increasing. A general physical decline of all organ systems and a high frequency of chronic disease accompanying aging.Comorbidity and polypharmacy are therefore common in the elderly. Hence, the...... administration of general anesthesia to the elderly can be a very challenging task. This paper aims to highlight some of the important issues presented to the elderly undergoing surgery and to suggest some strategies for management....

  20. Wireless Sensor Networks Energy-Efficient MAC Protocol

    Science.gov (United States)

    Lijuan, Du; Yuanpeng, Wang; WeiPeng, Jing

    This paper presents a new wireless sensor network energy-efficient MAC protocol, ES-MAC protocol, and shows the results of simulation experiments. During the transmission the nodes do not send ACK packages while use a small amount of new information packets, so they can reduce unnecessary energy loss and wasted time. The theoretical analysis and simulation results show that ES-MAC protocol reduces energy consumption while reducing network latency and improving network throughput.

  1. Towards Secure and Practical MACs for Body Sensor Networks

    OpenAIRE

    Gong, Z; Hartel, P.H.; Nikova, S.I.; Zhu, Bo

    2009-01-01

    Wireless sensor network (WSN) commonly requires lower level security for public information gathering, whilst body sensor network (BSN) must be secured with strong authenticity to protect personal health information. First in this paper, some practical problems with the Message Authentication Codes (MACs), which are suggested in the current security architectures for WSN, are reconsidered. The analysis exploits the fact that the recommended MACs for WSN, e.g., TinySec (CBC-MAC), MiniSec (OCB-...

  2. MAC Address as a Key for Data Encryption

    OpenAIRE

    Al-Husainy, Dr. Mohammed Abbas Fadhil

    2013-01-01

    In computer networking, the Media Access Control (MAC) address is a unique value associated with a network adapter. MAC addresses are also known as hardware addresses or physical addresses. TCP/IP and other mainstream networking architectures generally adopt the OSI model. MAC addresses function at the data link layer (layer 2 in the OSI model). They allow computers to uniquely identify themselves on a network at this relatively low level. In this paper, suggested data encryption technique is...

  3. SPLIT SKIN GRAFT HARVESTING UNDER LOCAL ANESTHESIA INFILTRATION VERSUS TOPICAL LOCAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Shahi

    2014-04-01

    Full Text Available OBJECTIVE: To compare the effectiveness of topical local anesthesia using PRILOX cream versus local anesthesia infiltration using lignocaine and adrenaline in harvesting split skin graft. METHODS: A prospective study of 58 patients requiring split skin graft was carried. One group comprising 29 patients underwent harvesting of split skin graft under topical local anesthesia using PRILOX cream while the other group had local anesthesia infiltration using lignocaine and adrenaline. RESULTS: There were no significant differences between the 2 groups in terms of operating time, per operative pain, post-operative pain and post-operative requirement of analgesia. There was significant difference in time and pain during administration of local anesthesia and patient’s acceptability/ satisfaction with method of anesthesia. CONCLUSION: Topical local anesthesia using PRILOX cream can be used effectively for harvesting of split skin graft and is good alternative to local anesthesia infiltration.

  4. Essential Mac OS X panther server administration integrating Mac OS X server into heterogeneous networks

    CERN Document Server

    Bartosh, Michael

    2004-01-01

    If you've ever wondered how to safely manipulate Mac OS X Panther Server's many underlying configuration files or needed to explain AFP permission mapping--this book's for you. From the command line to Apple's graphical tools, the book provides insight into this powerful server software. Topics covered include installation, deployment, server management, web application services, data gathering, and more

  5. A Mobile Automated Characterization System (MACS) for indoor floor characterization

    International Nuclear Information System (INIS)

    The Savannah River Technology Center (SRTC) and Oak Ridge National Laboratory are developing an advanced Mobile Automated Characterization System (MACS) to characterize indoor contaminated floors. MACS is based upon Semi-Intelligent Mobile Observing Navigator (SIMON), an earlier floor characterization system developed at SRTC. MACS will feature enhanced navigation systems, operator interface, and an interface to simplify integration of additional sensors. The enhanced navigation system will provide the capability to survey large open areas much more accurately than is now possible with SIMON, which is better suited for hallways and corridors that provide the means for recalibrating position and heading. MACS operator interface is designed to facilitate MACS's use as a tool for health physicists, thus eliminating the need for additional training in the robot's control language. Initial implementation of MACS will use radiation detectors. Additional sensors, such as PCB sensors currently being developed, will be integrated on MACS in the future. Initial use of MACS will be focused toward obtaining comparative results with manual methods. Surveys will be conducted both manually and with MACS to compare relative costs and data quality. While clear cost benefits anticipated, data quality benefits should be even more significant

  6. Mac OS X Snow Leopard Server For Dummies

    CERN Document Server

    Rizzo, John

    2009-01-01

    Making Everything Easier!. Mac OS® X Snow Leopard Server for Dummies. Learn to::;. Set up and configure a Mac network with Snow Leopard Server;. Administer, secure, and troubleshoot the network;. Incorporate a Mac subnet into a Windows Active Directory® domain;. Take advantage of Unix® power and security. John Rizzo. Want to set up and administer a network even if you don't have an IT department? Read on!. Like everything Mac, Snow Leopard Server was designed to be easy to set up and use. Still, there are so many options and features that this book will save you heaps of time and effort. It wa

  7. Study on intracellular trafficking of Mac-1 by direct visualization

    Institute of Scientific and Technical Information of China (English)

    YAN Ming; MAO Jifang; WEI Yi; ZHONG Jigen; YANG Shengsheng; XU Renbao

    2004-01-01

    Previously, we constructed DNA vectors containing cDNA of Mac-1 subunits (CD11b or CD18b) fused with fluorescence protein (FP). cDNA fragments and the DNA constructs were then transfected into CHO cells (as CHO-Mac-1-FP). The structure and function of Mac-1-FP obtained from the CHO-Mac-1-FP cells are nearly identical to that expressed in wild type leukocytes. In the present study, the intracellular trafficking of Mac-1 was visualized directly by monitoring the fluorescent intensities of YFP-CD18 and PE-conjugated monoclonal antibody against CD11b under a confocal microscope in CHO-Mac-1-FP cells. The results indicate that: (ⅰ) although Mac-1 was not detected in the cell membrane at resting state, it had been translocated and clustered into the cell membrane by 1 h and internalized 2 h after PMA stimulation, at which point the fluorescence intensity began to diminish gradually, probably due to partial degradation of Mac-1. The fluorescence of CD18 and CD11b reappeared on the cell membrane 1 h after re-treatment with PMA, suggesting the recycling of non-degraded Mac-1. (ⅱ) The adhesion rate of CHO-Mac-1-FP to magnetic beads coupled ICAM-1 increased within 4 h after their initial interaction, accompanied by the clustering of Mac-1-FP. After 8 h,the adhesion rate declined and fluorescence also decreased simultaneously. The pattern of change in fluorescence in CHO-Mac-1-FP cells elicited by ICAM-1 beads was similar to that elicited by PMA, suggesting that endocytosis and degradation of Mac-1 occurred after the interaction with ICAM-1. Thus, we conclude that the intracellular trafficking of Mac-1 after activation is associated with membrane translocation, endocytosis, degradation and recycling. These changes are in parallel with the adhesion of CHO-Mac-1-FP cells with ICAM-1, and may be involved in the adhesion and detachment of leukocytes. The detachment of leukocytes may be caused by endocytosis of Mac-1.

  8. Energy-efficient MAC protocols for Wireless Sensor Networks

    Institute of Scientific and Technical Information of China (English)

    Li De-liang; Peng Fei

    2009-01-01

    Designing energy-efficient Medium Access Control (MAC) protocols has a significant influence on the energy performance of wireless sensor network (WSN). In this paper we present a survey of the recent typical MAC protocols regarding energy efficiency for WSN. According to channel access policies, we classify these protocols into four categories: contention-based, TDMA-based, hybrid, and cross layer protocols, in which the advantages and disadvantages in each class of MAC protocols are discussed. Finally, we point out open research issues that need to carry on to achieve high energy efficiency for the design of MAC protocols in WSN.

  9. DCP, a distributed-control polling mac protocol

    OpenAIRE

    Conti, Marco; Gregori, Enrico; Lenzini, Luciano

    1990-01-01

    This paper describes and analyzes a novel MAC protocol named Distributed-Control Polling (DCP), which has been designed to bring together the most interesting features of distributed-control MAC protocols (e.g., DQDB) and centralized token-passing MAC protocols (e.g. FASNET, FDDI, EXPRESS_NET). From the fully?distributed MAC protocols, DCP acquires the capability to guarantee both a complete utilization of the medium capacity and an access delay of only a few slots at light loads. From the ce...

  10. Survey of international regional anesthesia fellowship directors

    OpenAIRE

    Lansdown AK; McHardy PG; Patel SC; Nix CM; McCartney CJL

    2013-01-01

    Andrew K Lansdown,1,2 Paul G McHardy,1 Sanjiv C Patel,1,3 Catherine M Nix,1 Colin JL McCartney1 1Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; 2University of Sydney, Sydney, NSW, Australia; 3University College Hospital, London, UK Background: The scope of regional anesthesia fellowship programs has not been analyzed but may provide insights that could improve fellowship training and standards. Methods: Regional anesthesia fellowship ...

  11. Hypotensive Anesthesia versus Normotensive Anesthesia during Major Maxillofacial Surgery: A Review of the Literature

    OpenAIRE

    2015-01-01

    Steady blood pressure within normal limits during surgery is one of the markers of the ideal and skillful anesthesia. Yet, reduced blood pressure is advantageous in some settings because it can contribute to a reduction in overall blood loss and improve the surgical field conditions. Controlled hypotension during anesthesia or hypotensive anesthesia is often used in major maxillofacial operations. Since hypotensive anesthesia carries the risk of hypoperfusion to important organs and tissues, ...

  12. General anesthesia plus ilioinguinal nerve block versus spinal anesthesia for ambulatory inguinal herniorrhapy

    OpenAIRE

    Lucía Vizcaíno-Martínez; Manuel Ángel Gómez-Ríos; Beatriz López-Calviño

    2014-01-01

    Objective: The aim was to evaluate general anesthesia (GA) plus ilioinguinal nerve block (IIB) versus spinal anesthesia (SA) in patients scheduled for ambulatory inguinal hernia repair regarding pain management, anesthesia recovery and reducing potential complications. Materials and Methods: A double-blind, prospective, randomized, controlled study in patients American Society of Anesthesiologists I-III randomized into two groups: GA plus IIB group, induction of anesthesia with propofol, main...

  13. Anaesthesia with sevoflurane in pigeons: minimal anaesthetic concentration (MAC) determination and investigation of cardiorespiratory variables at 1 MAC.

    Science.gov (United States)

    Botman, J; Gabriel, F; Dugdale, A H A; Vandeweerd, J-M

    2016-05-28

    The objective of the study was to determine the minimal anaesthetic concentration (MAC) of sevoflurane (SEVO) in pigeons and investigate the effects of 1 MAC SEVO anaesthesia on cardiovascular and respiratory variables compared with the awake state. This is a prospective, experimental study. Animals were seven healthy adult pigeons. After acclimatisation to handling, heart rate (HR), heart rhythm, respiratory rate (fR), end-expired carbon dioxide tension (PE'CO2), inspired CO2 tension, indirect systolic arterial blood pressure (SAP) and cloacal temperature were measured to determine baseline, 'awake' values. Pigeons were then anaesthetised with SEVO and MAC was determined by the 'bracketing' method. The same variables were monitored during a 40 minute period at 1.0 MAC SEVO for each bird. Mean MAC was 3.0±0.6 per cent for SEVO. During maintenance of anaesthesia at 1.0 MAC, SAP decreased significantly (Ppigeons. PMID:27083873

  14. An Energy Efficient Analysis of S-MAC And H-MAC Protocols for Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    P.T.Kalaivaani

    2013-04-01

    Full Text Available Wireless Sensor Networks (WSNs is an interesting topic to the researchers because of its variousapplications. The applications are health monitoring and environmental monitoring, Industrial ProcessMonitoring, Target detection, Target tracking, Energy Efficiency, Disaster Management and MilitarySecurity Systems. The wireless medium requires highly optimized medium Access Protocols to avoidinterferences. Limited resources have driven the research towards energy consumption of MACfunctionalities. Two Medium Access Control (MAC protocol performances are analyzed by using the MAClayer frame work for wireless sensor networks. In this paper an energy efficient analysis of S-MAC and HMACprotocols for wireless sensor networks is proposed with spatial correlation concept. Two MACprotocols such as Sensor MAC (S-MAC and Hybrid MAC (H-MAC protocols are proposed to analyze theperformance of Wireless Sensor Network using four different Parameters such as End to End delay, PacketDelivery Ratio, Packet Drop Rate and Energy Consumption. Performance analysis is carried out by usingthe simulation tool NS2.

  15. Assessing pain responses during general anesthesia.

    Science.gov (United States)

    Stomberg, M W; Sjöström, B; Haljamäe, H

    2001-06-01

    Major technical and pharmacological achievements in recent years have greatly influenced the practice of anesthesia. Clinical signs related to the main aspects of anesthesia, i.e., hypnosis, analgesia, and muscular relaxation, are increasingly obtainable from variables supplied by the monitoring equipment. It is not known, however, to what extent more indirect, patient-associated clinical signs of pain/depth of anesthesia are still considered of importance and relied on in the intraoperative management of surgical patients. The aims of the present study were to assess what clinical signs, indirect as well as monitor-derived, are considered indicative of intraoperative pain or depth of anesthesia by nurse anesthetists during general anesthesia. In connection with anesthetic management of surgical patients, Swedish nurse anesthetists (N = 40) were interviewed about clinical signs that they routinely assessed and were asked if the observed signs were considered indicative mainly of intraoperative pain or depth of anesthesia. It was found that skin-associated responses (temperature, color, moisture/stickiness) were commonly considered to indicate intraoperative pain rather than depth of anesthesia. Respiratory movements, eye reactions, and circulatory responses were considered to be indicative of either pain or insufficient depth of anesthesia. The present data indicate that indirect physiological signs are still considered of major importance by anesthesia nurses during the anesthetic management of surgical patients. PMID:11759565

  16. TreeMAC: Localized TDMA MAC protocol for real-time high-data-rate sensor networks

    Science.gov (United States)

    Song, W.-Z.; Huang, R.; Shirazi, B.; LaHusen, R.

    2009-01-01

    Earlier sensor network MAC protocols focus on energy conservation in low-duty cycle applications, while some recent applications involve real-time high-data-rate signals. This motivates us to design an innovative localized TDMA MAC protocol to achieve high throughput and low congestion in data collection sensor networks, besides energy conservation. TreeMAC divides a time cycle into frames and each frame into slots. A parent node determines the children's frame assignment based on their relative bandwidth demand, and each node calculates its own slot assignment based on its hop-count to the sink. This innovative 2-dimensional frame-slot assignment algorithm has the following nice theory properties. First, given any node, at any time slot, there is at most one active sender in its neighborhood (including itself). Second, the packet scheduling with TreeMAC is bufferless, which therefore minimizes the probability of network congestion. Third, the data throughput to the gateway is at least 1/3 of the optimum assuming reliable links. Our experiments on a 24-node testbed show that TreeMAC protocol significantly improves network throughput, fairness, and energy efficiency compared to TinyOS's default CSMA MAC protocol and a recent TDMA MAC protocol Funneling-MAC. Partial results of this paper were published in Song, Huang, Shirazi and Lahusen [W.-Z. Song, R. Huang, B. Shirazi, and R. Lahusen, TreeMAC: Localized TDMA MAC protocol for high-throughput and fairness in sensor networks, in: The 7th Annual IEEE International Conference on Pervasive Computing and Communications, PerCom, March 2009]. Our new contributions include analyses of the performance of TreeMAC from various aspects. We also present more implementation detail and evaluate TreeMAC from other aspects. ?? 2009 Elsevier B.V.

  17. General anesthesia-associatedDNA damage in peripheral blood mononuclear cells of surgical patients

    Institute of Scientific and Technical Information of China (English)

    Wang Haiyan; Zhou Qi; Fu Huo

    2011-01-01

    Objective:To evaluate retrospectively the effect of general anesthesia onDNA damage in the blood mononuclear cells (PBMCs) of surgical patients in order to provide evidence for a better nursing care during the procedure.Methods: Clinical charts of76 patients who underwent operation under general anesthesia and76 healthy control subjects with documented results of DNA damage extent inPBMCs from the single-cell gel electrophoresis(SCGE) or comet assay and serum contents of superoxide dismutase(SOD) and malondialdehyde(MDA)from biochemical analyses were reviewed. The percentage of comet PBMCs and tailDNAand serum contents of SOD and MAD were analyzed by student t-test.Results: Compared with healthy control subjects, generally anesthetized surgical patients had significantly higher % cometPBMCs and % tail DNA(P<0.05) and significantly lower serum concentrations ofSOD (P<0.05) and significantly higher serum concentrations ofMAD (P<0.05). Compared with levels before general anesthesia in surgical patients, % cometPBMCs, % tailDNA, and serum levels ofMADwere significantly higher (P<0.05 or0.01), and serum levels ofSOD were significantly lower (P<0.05), after general anesthesia.Conclusions: General anesthesia during surgery causes a certain degree of hypoxia and PBMC damage. Particular attention should be paid to monitoring and maintenance of blood oxygen saturation in patients undergoing surgery under general anesthesia.

  18. Local anesthesia for prostate brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To demonstrate the technique and feasibility of prostate brachytherapy performed with local anesthesia only. Methods and Materials: A 5 by 5 cm patch of perineal skin and subcutaneous tissue is anesthetized by local infiltration of 10 cc of 1% lidocaine with epinephrine, using a 25-gauge 5/8-inch needle. Immediately following injection into the subcutaneous tissues, the deeper tissues, including the pelvic floor and prostate apex, are anesthetized by injecting 15 cc lidocaine solution with approximately 8 passes of a 20-gauge 1.0-inch needle. Following subcutaneous and peri-apical lidocaine injections, the patient is brought to the simulator suite and placed in leg stirrups. The transrectal ultrasound (TRUS) probe is positioned to reproduce the planning images and a 3.5- or 6.0-inch, 22-gauge spinal needle is inserted into the peripheral planned needle tracks, monitored by TRUS. When the tips of the needles reach the prostatic base, about 1 cc of lidocaine solution is injected in the intraprostatic track, as the needle is slowly withdrawn, for a total volume of 15 cc. The implants are done with a Mick Applicator, inserting and loading groups of two to four needles, so that a maximum of only about four needles are in the patient at any one time. During the implant procedure, an additional 1 cc of lidocaine solution is injected into one or more needle tracks if the patient experiences substantial discomfort. The total dose of lidocaine is generally limited to 500 mg (50 ml of 1% solution). Results: To date, we have implanted approximately 50 patients in our simulator suite, using local anesthesia. Patients' heart rate and diastolic blood pressure usually showed moderate changes, consistent with some discomfort. The time from first subcutaneous injection and completion of the source insertion ranged from 35 to 90 minutes. Serum lidocaine levels were below or at the low range of therapeutic. There has been only one instance of acute urinary retention in the

  19. Multi-channel MAC Protocol in Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    Yongli Sun

    2013-11-01

    Full Text Available Since cognitive wireless network (CRN has the characteristic of secondary use, it can enable the device to dynamically access available spectrum without interference to primary users (PUs, which can effectively alleviate contradiction between the lack of spectrum resources and the growing demand for wireless access. However, Medium Access Control (MAC protocol as CRN core components, can achieve competition access of the licensed spectrum and coordination control, which will maximize spectrum utilization efficiency and network throughput. The contribution of this survey is threefold. First, we analyze the characteristics of the existed multi- channel MAC protocol in CRN; Second, according to the different ways of spectrum access in CRNs, the multi-channel MAC protocols are classified into time-slotted based MAC protocol, control channel based MAC protocol and hybrid MAC protocol, and the paper emphatically analyzed the advantages and disadvantages of these multi-channel MAC protocols; Finally, the paper explores the difficulties and the challenges of multi-channel MAC protocols design in cognitive wireless network.

  20. Counter Measures to Combat Misuses of MAC Address Spoofing Techniques

    Directory of Open Access Journals (Sweden)

    Alok Pandey

    2012-03-01

    Full Text Available In a computer network several communicating devices are connected to a common shared communication medium. A network interfacing card or a wireless network card is typically used to connect computers on a network. This gives rise to the need of unique identification mechanism to be followed for each of the connected devices. Media Access Control (MAC addressing is used to properly identify communicating devices. The term MAC spoofing refers to a situation when somebody changes the MAC address of his computer or the network communicating device to impersonate someone else based upon this MAC address identification. Although MAC spoofing may be essential in some situations yet it has become potential threat for the network security as it sets ground for formulating and launching different types of Attacks like ARP Spoofing, DNS Poisoning, Denial of Services, Session Hijacking, Man in the Middle Attack etc. on a network. The purpose of this paper is to spread the awareness about MAC addressing, MAC spoofing techniques normally used, different types of attacks that can be based upon MAC spoofing and some of the counter measures that can be adopted by common network users.

  1. Steven MacCall: Winner of LJ's 2010 Teaching Award

    Science.gov (United States)

    Berry, John N., III

    2010-01-01

    This article profiles Steven L. MacCall, winner of "Library Journal's" 2010 Teaching Award. An associate professor at the School of Library and Information Studies (SLIS) at the University of Alabama, Tuscaloosa, MacCall was nominated by Kathie Popadin, known as "Kpop" to the members of her cohort in the online MLIS program at SLIS. Sixteen of…

  2. Paradox applications integration ATP's for MAC and mass balance programs

    International Nuclear Information System (INIS)

    The K Basins Materials Accounting (MAC) and Material Balance (MBA) database system were set up to run under one common applications program. This Acceptance Test Plan (ATP) describes how the code was to be tested to verify its correctness. The scope of the tests is minimal, since both MAC and MBA have already been tested in detail as stand-alone programs

  3. Energy Efficient MAC Protocols for Wireless Sensor Network: A Survey

    Directory of Open Access Journals (Sweden)

    Eleazar Chukwuka

    2013-08-01

    Full Text Available Wireless Sensor Network (WSN is an attractive choice for a variety of applications as no wiredinfrastructure is needed. Other wireless networks are not as energy constrained as WSNs, because theymay be plugged into the mains supply or equipped with batteries that are rechargeable and replaceable.Among others, one of the main sources of energy depletion in WSN is communications controlled by theMedium Access Control (MAC protocols. An extensive survey of energy efficient MAC protocols ispresented in this article. We categorise WSN MAC protocols in the following categories: controlled access(CA, random access (RA, slotted protocols (SP and hybrid protocols (HP. We further discuss howenergy efficient MAC protocols have developed from fixed sleep/wake cycles through adaptive to dynamiccycles, thus becoming more responsive to traffic load variations. Finally we present open researchquestions on MAC layer design for WSNs in terms of energy efficiency.

  4. A Sensing Error Aware MAC Protocol for Cognitive Radio Networks

    CERN Document Server

    Hu, Donglin

    2011-01-01

    Cognitive radios (CR) are intelligent radio devices that can sense the radio environment and adapt to changes in the radio environment. Spectrum sensing and spectrum access are the two key CR functions. In this paper, we present a spectrum sensing error aware MAC protocol for a CR network collocated with multiple primary networks. We explicitly consider both types of sensing errors in the CR MAC design, since such errors are inevitable for practical spectrum sensors and more important, such errors could have significant impact on the performance of the CR MAC protocol. Two spectrum sensing polices are presented, with which secondary users collaboratively sense the licensed channels. The sensing policies are then incorporated into p-Persistent CSMA to coordinate opportunistic spectrum access for CR network users. We present an analysis of the interference and throughput performance of the proposed CR MAC, and find the analysis highly accurate in our simulation studies. The proposed sensing error aware CR MAC p...

  5. Pain management and regional anesthesia for the dental patient.

    Science.gov (United States)

    Woodward, Tony M

    2008-05-01

    Current standards of care in veterinary medicine dictate an adequate level of pain control for our patients. Effective pain control uses a proactive, multimode approach that starts with preoperative medications, includes the anesthetic protocol selected, and continues into the postoperative period. A basic understanding of the physiology of pain assists in selecting those agents and modalities best suited for individual patients. Analgesic drug selection and local anesthesia are both integral parts of pain control when performing surgery in the oral cavity. Local (regional) anesthesia plays an important part in the pain control of oral surgical patients. Regional anesthetic techniques are used for many common oral procedures, including extractions, periodontal flap surgery, treatment of traumatic injuries of the oral cavity, tumor removal, palatal surgery, periodontal therapy, and root canal therapy. This presentation will cover strategies for analgesia and the techniques and materials used in local/regional anesthesia in the oral cavity. Anatomic landmarks and guidelines for effective regional blocks will be covered. PMID:18482711

  6. [Voluntary interruption of pregnancy: anesthesia or sophrology].

    Science.gov (United States)

    Ferragut, E

    1979-10-01

    General anesthesia during induced abortion has the great advantage of eliminating any physical pain; it does not do anything, however, for anxiety, guilt feeling, emotional upheaval, and postoperative depression. This study investigate sophrology, a form of anesthesia without medication, which diminishes psychic tension through comforting and sympathetic words, and corporal tension through relaxation. At the beginning of the study, which observed 7547 patients, general anesthesia was routinely used for all induced abortion patients; after 4 years of observation, general anesthesia was used on about 1.9% of patients. Judging from a questionnaire given to patients after intervention 75% of patients were completely satisfied from an emotional point of view; the same percentage judged the procedure a bit painful, but bearable; only 3.5% of patients regretted not to have opted for general anesthesia. PMID:12158285

  7. Severe tracheobronchial compression in a patient with Turner's syndrome undergoing repair of a complex aorto-subclavian aneurysm: anesthesia perspectives.

    Science.gov (United States)

    Hudson, Christopher C C; Stewart, Jeremie; Dennie, Carole; Malas, Tarek; Boodhwani, Munir

    2014-01-01

    We present a case of severe tracheobronchial compression from a complex aorto-subclavian aneurysm in a patient with Turner's syndrome undergoing open surgical repair. Significant airway compression is a challenging situation and requires careful preoperative preparation, maintenance of spontaneous breathing when possible, and consideration of having an alternative source of oxygenation and circulation established prior to induction of general anesthesia. Cardiopulmonary monitoring is essential for safe general anesthesia and diagnosis of unexpected intraoperative events. PMID:25281630

  8. Effect of preoperative oral midazolam sedation on separation anxiety and emergence delirium among children undergoing dental treatment under general anesthesia

    OpenAIRE

    El Batawi, Hisham Yehia

    2015-01-01

    Aim: To investigate the possible effects of preoperative oral Midazolam on parental separation anxiety, emergence delirium, and post-anesthesia care unit time on children undergoing dental rehabilitation under general anesthesia. Methods: Randomized, prospective, double-blind study. Seventy-eight American Society of Anesthesiology (ASA) I children were divided into two groups of 39 each. Children of the first group were premedicated with oral Midazolam 0.5 mg/kg, while children of the control...

  9. TR-MAC: an energy-efficient MAC protocol exploiting transmitted reference modulation for wireless sensor networks

    NARCIS (Netherlands)

    Morshed, Sarwar; Heijenk, Geert

    2014-01-01

    The medium access control (MAC) protocol determines the energy consumption of a wireless sensor node by specifying the listening, transmitting or sleeping time. Therefore MAC protocols play an important role in minimizing the overall energy consumption in a typical wireless sensor network (WSN). Usi

  10. Sedation or general anesthesia for transcatheter aortic valve implantation (TAVI).

    Science.gov (United States)

    Mayr, N Patrick; Michel, Jonathan; Bleiziffer, Sabine; Tassani, Peter; Martin, Klaus

    2015-09-01

    Transfemoral transcatheter aortic valve implantation (TAVI) is nowadays a routine therapy for elderly patients with severe aortic stenosis (AS) and high perioperative risk. With growing experience, further development of the devices, and the expansion to "intermediate-risk" patients, there is increasing interest in performing this procedure under conscious sedation (TAVI-S) rather than the previously favoured approach of general anesthesia (TAVI-GA). The proposed benefits of TAVI-S include; reduced procedure time, shorter intensive care unit (ICU) length of stay, reduced need for intraprocedural vasopressor support, and the potential to perform the procedure without the direct presence of an anesthetist for cost-saving reasons. To date, no randomized trial data exists. We reviewed 13 non-randomized studies/registries reporting data from 6,718 patients undergoing TAVI (3,227 performed under sedation). Patient selection, study methods, and endpoints have differed considerably between published studies. Reported rates of in-hospital and longer-term mortality are similar for both groups. Up to 17% of patients undergoing TAVI-S require conversion to general anesthesia during the procedure, primarily due to vascular complications, and urgent intubation is frequently associated with hemodynamic instability. Procedure related factors, including hypotension, may compound preexisting age-specific renal impairment and enhance the risk of acute kidney injury. Hypotonia of the hypopharyngeal muscles in elderly patients, intraprocedural hypercarbia, and certain anesthetic drugs, may increase the aspiration risk in sedated patients. General anesthesia and conscious sedation have both been used successfully to treat patients with severe AS undergoing TAVI with similar reported short and long-term mortality outcomes. The authors believe that the significant incidence of complications and unplanned conversion to general anesthesia during TAVI-S mandates the start-to-finish presence

  11. Anesthesia

    Science.gov (United States)

    ... of external growths. Although alcohol, opium or other botanicals sometimes helped alleviate the agony, most surgical patients ... of the population, such as the elderly or cancer survivors, will reveal whether certain anesthetics are better ...

  12. Inhalational anesthesia for organ procurement: potential indications for administering inhalational anesthesia in the brain-dead organ donor.

    Science.gov (United States)

    Elkins, Laurie J

    2010-08-01

    Organs needed for transplantation far outweigh their availability. There is minimal research regarding perioperative care of the brain-dead organ donor during the procurement procedure. Current research attributes a great deal of organ damage to autonomic or sympathetic storm that occurs during brain death. Literature searches were performed with the terms brain death, organ donor, organ procurement, anesthesia and organ donor, anesthesia and brain death, anesthesia and organ procurement, inhalational anesthetics and organ procurement, and inhalational anesthetics and brain dead. Additional resources were obtained from reference lists of published articles. The literature review showed there is a lack of published studies researching the use of inhalational anesthetics in organ procurement. No studies have been published evaluating the effect of preconditioning with inhalational agents (administering 1.3 minimal alveolar concentration of an inhalational agent for the 20 minutes before periods of ischemia) in the brain-dead organ donor population. Further studies are required to determine if administration of inhalational anesthetics reduces catecholamine release occurring with surgical stimulation during the organ procurement procedure and whether this technique increases viability of transplanted organs. Anesthetic preconditioning before the ischemic period may reduce ischemia-reperfusion injury in transplanted organs, further increasing viability of transplanted organs. PMID:20879630

  13. Leaving More Than Your Fingerprint on the Intravenous Line: A Prospective Study on Propofol Anesthesia and Implications of Stopcock Contamination

    Science.gov (United States)

    Cole, Devon C.; Baslanti, Tezcan Ozrazgat; Gravenstein, Nikolaus L.; Gravenstein, Nikolaus

    2013-01-01

    Introduction Acute care handling of IV stopcocks during anesthesia and surgery may result in contaminated IV tubing sets. In the context of widespread propofol use, a nutrient-rich hypnotic drug, we hypothesized that propofol anesthesia increases bacterial contamination of IV stopcocks and may compromise safety of IV tubing sets when continued to be used after propofol anesthesia. Methods We conducted an in vitro trial by collecting IV tubing sets at the time of patient discharge from same-day ambulatory procedures performed with and without propofol anesthesia. These extension sets were then held at room temperature for 6, 24, or 48 hours. We cultured 50 samples at each interval for both cohorts. Quantitative cultures were done by aspirating the IV stopcock dead space and plating the aspirate on blood agar for colony count and speciation. Results Positive bacterial counts were recovered from 17.3% of propofol anesthesia stopcocks (26/150) and 18.6% of non-propofol stopcocks (28/150). At 6 hours, the average bacterial counts from stopcocks with visible residual propofol was 44 colony forming units (CFU)/mL, compared to 41 CFU/mL with no visible residual propofol and 37 CFU/mL in non-propofol anesthesia stopcocks. There was a 100-fold increase in bacterial number in contaminated stopcock dead spaces at 48 hours after propofol anesthesia. This difference remained significant when comparing positive counts from stopcocks with no visible residual propofol and non-propofol anesthesia (p-value=0.034). Conclusion There is a covert incidence and degree of IV stopcock bacterial contamination during anesthesia which is aggravated by propofol anesthetic. Propofol anesthesia may increase risk for postoperative infection because of bacterial growth in IV stopcock dead spaces. PMID:23749446

  14. Peribulbar anesthesia for the repair of orbital floor fractures.

    Science.gov (United States)

    Kezirian, G M; Hill, F D; Hill, F J

    1991-10-01

    Four patients underwent successful repair of an isolated orbital floor fracture under local anesthesia. The surgical approach was by antero-inferior orbitotomy, with placement of a Nylamid plate (S Jackson Inc, Washington, DC). The anesthetic technique used was a peribulbar and infratrochlear nerve block with local supplementation. Digital control of the globe was maintained during the peribulbar injection to prevent ocular perforation. We conclude that local anesthetic for this procedure in carefully selected cases is safe and efficacious, avoiding the morbidity of a general anesthetic. PMID:1961618

  15. Traducir con ordenadores Mac, ¿es posible?

    Directory of Open Access Journals (Sweden)

    Fernando Vidal Carballido

    2009-06-01

    Full Text Available El creciente éxito de los productos de Apple y el impulso que esto ha supuesto para su sistema operativo, Mac OS X, hace que cada vez haya más traductores que se planteen la opción de dejar de utilizar Windows a favor del sistema operativo de Apple. En el presente artículo se ofrece una perspectiva general sobre la situación actual y las distintas opciones, desde el uso de Windows en ordenadores Mac hasta el abandono completo de Microsoft Windows para usar Mac OS X en exclusiva. ----------------------------------- Translating with Mac. Is it possible? The growing success of Apple's products and the resulting popularity of its operating system, Mac OS X, are moving an increasing number of translators to consider the replacement of their Windows by the Apple's OS. This article offers an overview of the current situation and different options available, from using Windows on Mac computers to completely migrating from Microsoft Windows to Mac OS X.

  16. Strategies for Optimal MAC Parameters Tuning in IEEE 802.15.6 Wearable Wireless Sensor Networks.

    Science.gov (United States)

    Alam, Muhammad Mahtab; Ben Hamida, Elyes

    2015-09-01

    Wireless body area networks (WBAN) has penetrated immensely in revolutionizing the classical heath-care system. Recently, number of WBAN applications has emerged which introduce potential limits to existing solutions. In particular, IEEE 802.15.6 standard has provided great flexibility, provisions and capabilities to deal emerging applications. In this paper, we investigate the application-specific throughput analysis by fine-tuning the physical (PHY) and medium access control (MAC) parameters of the IEEE 802.15.6 standard. Based on PHY characterizations in narrow band, at the MAC layer, carrier sense multiple access collision avoidance (CSMA/CA) and scheduled access protocols are extensively analyzed. It is concluded that, IEEE 802.15.6 standard can satisfy most of the WBANs applications throughput requirements by maximum achieving 680 Kbps. However, those emerging applications which require high quality audio or video transmissions, standard is not able to meet their constraints. Moreover, delay, energy efficiency and successful packet reception are considered as key performance metrics for comparing the MAC protocols. CSMA/CA protocol provides the best results to meet the delay constraints of medical and non-medical WBAN applications. Whereas, the scheduled access approach, performs very well both in energy efficiency and packet reception ratio. PMID:26266628

  17. Effect of general anesthesia and orthopedic surgery on serum tryptase

    DEFF Research Database (Denmark)

    Garvey, Lene H; Bech, Birgitte Louise; Mosbech, Holger; Krøigaard, Mogens; Belhage, Bo; Husum, Bent; Poulsen, Lars K

    2010-01-01

    Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study was to...... investigate the effect of anesthesia and surgery on serum tryptase in the absence of anaphylaxis....

  18. MacRuby Ruby and Cocoa on OS X

    CERN Document Server

    Aimonetti, Matt

    2011-01-01

    Want to build native Mac OS X applications with a sleek, developer-friendly alternative to Objective-C? MacRuby is an ideal choice. This in-depth guide shows you how Apple's implementation of Ruby gives you access to all the features available to Objective-C programmers. You'll get clear, detailed explanations of MacRuby, including quick programming techniques such as prototyping. Perfect for programmers at any level, this book is packed with code samples and complete project examples. If you use Ruby, you can tap your skills to take advantage of Interface Builder, Cocoa libraries, the Objec

  19. Cooperative Energy Harvesting-Adaptive MAC Protocol for WBANs

    Science.gov (United States)

    Esteves, Volker; Antonopoulos, Angelos; Kartsakli, Elli; Puig-Vidal, Manel; Miribel-Català, Pere; Verikoukis, Christos

    2015-01-01

    In this paper, we introduce a cooperative medium access control (MAC) protocol, named cooperative energy harvesting (CEH)-MAC, that adapts its operation to the energy harvesting (EH) conditions in wireless body area networks (WBANs). In particular, the proposed protocol exploits the EH information in order to set an idle time that allows the relay nodes to charge their batteries and complete the cooperation phase successfully. Extensive simulations have shown that CEH-MAC significantly improves the network performance in terms of throughput, delay and energy efficiency compared to the cooperative operation of the baseline IEEE 802.15.6 standard. PMID:26029950

  20. MacWilliams Identity for Codes with the Rank Metric

    Directory of Open Access Journals (Sweden)

    Gadouleau Maximilien

    2008-01-01

    Full Text Available Abstract The MacWilliams identity, which relates the weight distribution of a code to the weight distribution of its dual code, is useful in determining the weight distribution of codes. In this paper, we derive the MacWilliams identity for linear codes with the rank metric, and our identity has a different form than that by Delsarte. Using our MacWilliams identity, we also derive related identities for rank metric codes. These identities parallel the binomial and power moment identities derived for codes with the Hamming metric.

  1. Handling Deafness Problem of Scheduled Multi-Channel Polling MACs

    Science.gov (United States)

    Jiang, Fulong; Liu, Hao; Shi, Longxing

    Combining scheduled channel polling with channel diversity is a promising way for a MAC protocol to achieve high energy efficiency and performance under both light and heavy traffic conditions. However, the deafness problem may cancel out the benefit of channel diversity. In this paper, we first investigate the deafness problem of scheduled multi-channel polling MACs with experiments. Then we propose and evaluate two schemes to handle the deafness problem. Our experiment shows that deafness is a significant reason for performance degradation in scheduled multi-channel polling MACs. A proper scheme should be chosen depending on the traffic pattern and the design objective.

  2. Anesthesia with halothane and nitrous oxide alters protein and amino acid metabolism in dogs

    International Nuclear Information System (INIS)

    General anesthesia in combination with surgery is known to result in negative nitrogen balance. To determine whether general anesthesia without concomitant surgery decreases whole body protein synthesis and/or increases whole body protein breakdown, two groups of dogs were studied: Group 1 (n = 6) in the conscious state and Group 2 (n = 8) during general anesthesia employing halothane (1.5 MAC) in 50% nitrous oxide and oxygen. Changes in protein metabolism were estimated by isotope dilution techniques employing simultaneous infusions of [4,53H]leucine and alpha-[1-14C]-ketoisocaproate (KIC). Total leucine carbon flux was unchanged or slightly increased in the anesthetized animals when compared to the conscious controls, indicating only a slight increase in the rate of proteolysis. However, leucine oxidation was increased (P less than 0.001) by more than 80% in the anesthetized animals when compared with their conscious controls, whereas whole body nonoxidative leucine disappearance, an indicator of whole body protein synthesis, was decreased. The ratio of leucine oxidation to the nonoxidative rate of leucine disappearance, which provides an index of the catabolism of at least one essential amino acid in the postabsorptive state, was more than twofold increased (P less than 0.001) in the anesthetized animals regardless of the tracer employed. These studies suggest that the administration of anesthesia alone, without concomitant surgery, is associated with a decreased rate of whole body protein synthesis and increased leucine oxidation, resulting in increased leucine and protein catabolism, which may be underlying or initiating some of the protein wasting known to occur in patients undergoing surgery

  3. +Psychometric evaluation of the MacDQoL individualised measure of the impact of macular degeneration on quality of life

    Directory of Open Access Journals (Sweden)

    ffytche Timothy

    2005-04-01

    Full Text Available Abstract Background The MacDQoL is an individualised measure of the impact of macular degeneration (MD on quality of life (QoL. There is preliminary evidence of its psychometric properties and sensitivity to severity of MD. The aim of this study was to carry out further psychometric evaluation with a larger sample and investigate the measure's sensitivity to MD severity. Methods Patients with MD (n = 156: 99 women, 57 men, mean age 79 ± 13 years, recruited from eye clinics (one NHS, one private completed the MacDQoL by telephone interview and later underwent a clinic vision assessment including near and distance visual acuity (VA, comfortable near VA, contrast sensitivity, colour recognition, recovery from glare and presence or absence of distortion or scotoma in the central 10° of the visual field. Results The completion rate for the MacDQoL items was 99.8%. Of the 26 items, three were dropped from the measure due to redundancy. A fourth was retained in the questionnaire but excluded when computing the scale score. Principal components analysis and Cronbach's alpha (0.944 supported combining the remaining 22 items in a single scale. Lower MacDQoL scores, indicating more negative impact of MD on QoL, were associated with poorer distance VA (better eye r = -0.431 p Conclusion The MacDQoL 22-item scale has excellent internal consistency reliability and a single-factor structure. The measure is acceptable to respondents and the generic QoL item, MD-specific QoL item and average weighted impact score are related to several measures of vision. The MacDQoL demonstrates that MD has considerable negative impact on many aspects of QoL, particularly independence, leisure activities, dealing with personal affairs and mobility. The measure may be valuable for use in clinical trials and routine clinical care.

  4. Supplemental pulpal anesthesia for mandibular teeth

    Directory of Open Access Journals (Sweden)

    Thangavel Boopathi

    2013-01-01

    Full Text Available Clinical pulpal anesthesia is dependent on the interaction of three major factors. (1 the dentist (2 the patient and (3 local anesthesia. Many patients fear endodontic treatment due to a concern about pain. Although pain treatment is well managed in many endodontic patients, there exists a group of patients who do not receive adequate local anesthesia. The purpose of this review article is to discuss the possible reasons for pulpal anesthetic failures and also to focus on the measures for developing effective approaches for the same.

  5. PAD-MAC: primary user activity-aware distributed MAC for multi-channel cognitive radio networks.

    Science.gov (United States)

    Ali, Amjad; Piran, Md Jalil; Kim, Hansoo; Yun, Jihyeok; Suh, Doug Young

    2015-01-01

    Cognitive radio (CR) has emerged as a promising technology to solve problems related to spectrum scarcity and provides a ubiquitous wireless access environment. CR-enabled secondary users (SUs) exploit spectrum white spaces opportunistically and immediately vacate the acquired licensed channels as primary users (PUs) arrive. Accessing the licensed channels without the prior knowledge of PU traffic patterns causes severe throughput degradation due to excessive channel switching and PU-to-SU collisions. Therefore, it is significantly important to design a PU activity-aware medium access control (MAC) protocol for cognitive radio networks (CRNs). In this paper, we first propose a licensed channel usage pattern identification scheme, based on a two-state Markov model, and then estimate the future idle slots using previous observations of the channels. Furthermore, based on these past observations, we compute the rank of each available licensed channel that gives SU transmission success assessment during the estimated idle slot. Secondly, we propose a PU activity-aware distributed MAC (PAD-MAC) protocol for heterogeneous multi-channel CRNs that selects the best channel for each SU to enhance its throughput. PAD-MAC controls SU activities by allowing them to exploit the licensed channels only for the duration of estimated idle slots and enables predictive and fast channel switching. To evaluate the performance of the proposed PAD-MAC, we compare it with the distributed QoS-aware MAC (QC-MAC) and listen-before-talk MAC schemes. Extensive numerical results show the significant improvements of the PAD-MAC in terms of the SU throughput, SU channel switching rate and PU-to-SU collision rate. PMID:25831084

  6. The MacNuclide nuclear data environment

    International Nuclear Information System (INIS)

    Advance in technology have produced intriguing tools that can be applied to problems in nuclear science. Information management in nuclear science is an example of how technology is not quickly exploited. The U.S. Department of Energy supports an extensive program to evaluate published nuclear properties and store them in an electronic data base. Much of the evaluation effort has focused on producing the journal Nuclear Data Sheets and the publication Table of Isotopes. Although the electronic data base can itself be a valuable source of information, the software used to access is was designed using decades-old technologies. The authors of this paper have developed a novel data-base management system for nuclear properties. The application is known as MacNuclide. It is a nuclear data-base environment that uses the highly interactive and intuitive windowing environmentsof desk-top computers. The environment is designed around that image of the chart of nuclides. Questions are posed to the data base by placing constraints on properties and defining collections of nuclides to be used in data-base seraches. Results are displayed either as a simple list of nuclides that meet the imposed constraints or as a color chart of nuclides

  7. Infecting Windows, Linux & Mac in one go

    CERN Multimedia

    Computer Security Team

    2012-01-01

    Still love bashing on Windows as you believe it is an insecure operating system? Hold on a second! Just recently, a vulnerability has been published for Java 7.   It affects Windows/Linux PCs and Macs, Internet Explorer, Safari and Firefox. In fact, it affects all computers that have enabled the Java 7 plug-in in their browser (Java 6 and earlier is not affected). Once you visit a malicious website (and there are plenty already out in the wild), your computer is infected… That's "Game Over" for you.      And this is not the first time. For a while now, attackers have not been targeting the operating system itself, but rather aiming at vulnerabilities inherent in e.g. your Acrobat Reader, Adobe Flash or Java programmes. All these are standard plug-ins added into your favourite web browser which make your web-surfing comfortable (or impossible when you un-install them). A single compromised web-site, however, is sufficient to prob...

  8. A fuzzy logic cooperative MAC for MANET

    Institute of Scientific and Technical Information of China (English)

    WANG Zhao-xiang; XIA Hai-lun; DING Wei

    2008-01-01

    In both wireless local area networks (WLAN) andmobile ad hoc networks(MANET), the IEEE 802.11e mediumaccess control (MAC) protocol is proposed for an effectivequality of service (QoS) solution. A number of studies havebeen done to enhance the performance of 802.11e in MANETby independently adjusting contention window (CW) size ofeach access category(AC) in every node. However, without thecooperation between the high priority flows and lower priorityflows, the QoS goal of high priority flows cannot achieveeffectively. In this article, a fuzzy logic based cooperative MACprotocol (FLCMAC) is proposed to cooperate amongst networkflows and dynamically adjust access probability of each lowpriority flow affecting the high priority flows to satisfy theftQoS requirement. The simulation results indicate that comparedto the enhanced distributed channel access (EDCA) scheme of802.11e, the FLCMAC consistently excels, in terms ofthroughput and delay under moderate and heavy backgroundtraffic both in single-hop and multi-hop scenarios.

  9. Competition at the Wireless Sensor Network MAC Layer: Low Power Probing interfering with X-MAC

    International Nuclear Information System (INIS)

    Wireless Sensor Networks (WSNs) combine sensors with computer networks and enable very dense, in-situ and live measurements of data over a large area. Since this emerging technology has the potential to be embedded almost everywhere for numberless applications, interference between different networks can become a serious issue. For most WSNs, it is assumed today that the network medium access is non-competitive. On the basis of X-MAC interfered by Low Power Probing, this paper shows the danger and the effects of different sensor networks communicating on a single wireless channel of the 2.4 GHz band, which is used by the IEEE 802.15.4 standard.

  10. 324Mbps WLAN Equipment with MAC Frame Aggregation for High MAC-SAP Throughput

    OpenAIRE

    Suguru Kameda; Hiroyuki Nakase; Fumio Ishizu; Yoji Isota; Yoshihiko Shirokura; Akinori Fujimura; Yukimasa Nagai; Hiroshi Oguma; Kazuo Tsubouchi

    2006-01-01

    We developed a high speed wireless LAN prototype in the 5GHz band. Maximum transmission rate of the developed WLAN equipment was 324Mbit/sec using 6 multi-channels of 802.11a. We proposed a novel frame aggregation scheme to improve MAC efficiency. The proposed frame aggregation scheme ...

  11. Mac OS X : Tiger edition the missing manual

    CERN Document Server

    Pogue, David

    2005-01-01

    You can set your watch to it: As soon as Apple comes out with another version of Mac OS X, David Pogue hits the streets with another meticulous Missing Manual to cover it with a wealth of detail. The new Mac OS X 10.4, better known as Tiger, is faster than its predecessors, but nothing's too fast for Pogue and Mac OS X: The Missing Manual. There are many reasons why this is the most popular computer book of all time. With its hallmark objectivity, the Tiger Edition thoroughly explores the latest features to grace the Mac OS. Which ones work well and which do not? What should you look for? Th

  12. Rating of new outlet structures for MacFarlane Reservoir

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Memorandum explaining the new work on the outlet structure at MacFarlane Reservoir. Flow measurements were taken at different staff gage elevations and this data is...

  13. MAC layer security issues in wireless mesh networks

    Science.gov (United States)

    Reddy, K. Ganesh; Thilagam, P. Santhi

    2016-03-01

    Wireless Mesh Networks (WMNs) have emerged as a promising technology for a broad range of applications due to their self-organizing, self-configuring and self-healing capability, in addition to their low cost and easy maintenance. Securing WMNs is more challenging and complex issue due to their inherent characteristics such as shared wireless medium, multi-hop and inter-network communication, highly dynamic network topology and decentralized architecture. These vulnerable features expose the WMNs to several types of attacks in MAC layer. The existing MAC layer standards and implementations are inadequate to secure these features and fail to provide comprehensive security solutions to protect both backbone and client mesh. Hence, there is a need for developing efficient, scalable and integrated security solutions for WMNs. In this paper, we classify the MAC layer attacks and analyze the existing countermeasures. Based on attacks classification and countermeasures analysis, we derive the research directions to enhance the MAC layer security for WMNs.

  14. Design and Implementation of an Efficient 64 bit MAC

    Directory of Open Access Journals (Sweden)

    Mohammad Shabber Hasan Khan

    2015-08-01

    Full Text Available The design of optimized 64 bit multiplier and accumulator (MAC unit is implemented in this paper. MAC unit plays major role in many of the digital signal processing (DSP applications. The MAC unit is designed with the combinations of multipliers and adders. In the proposed method MAC unit is implemented using Vedic multiplier and the adder is done with ripple carry adder .The components are reduced by implementing Vedic multiplier using the techniques of Vedic mathematics that have been modified to improve performance. a high speed processor depends significantly on the multiplier as it is one of the key hardware blocks in most digital signal processing systems as well as in general processors. The area is optimized effectively using Vedic multiplier .The total design implemented using Xilinx.

  15. Big Mac arvestab raha ostujõudu / Harli Uljas

    Index Scriptorium Estoniae

    Uljas, Harli

    2005-01-01

    The Economist võrdleb maailma valuutade suhestamiseks Big Mac'i burgeri hindu 120 riigis, kuna see meetod võimaldab saada ülevaate riikide elanikkonna tegelikust ostujõust. Tabel: Hamburgeri standard

  16. Aeronautical Mobile Airport Communications System (AeroMACS)

    Science.gov (United States)

    Budinger, James M.; Hall, Edward

    2011-01-01

    To help increase the capacity and efficiency of the nation s airports, a secure wideband wireless communications system is proposed for use on the airport surface. This paper provides an overview of the research and development process for the Aeronautical Mobile Airport Communications System (AeroMACS). AeroMACS is based on a specific commercial profile of the Institute of Electrical and Electronics Engineers (IEEE) 802.16 standard known as Wireless Worldwide Interoperability for Microwave Access or WiMAX (WiMax Forum). The paper includes background on the need for global interoperability in air/ground data communications, describes potential AeroMACS applications, addresses allocated frequency spectrum constraints, summarizes the international standardization process, and provides findings and recommendations from the world s first AeroMACS prototype implemented in Cleveland, Ohio, USA.

  17. Mechatronical Aided Concept (MAC) in Intelligent Transport Vehicles Design

    OpenAIRE

    Pavel Pavlasek

    2003-01-01

    This article deals with the principles of synergy effect of mechatronical aided concept (MAC) to the design of intelligent transport vehicles products applying CA technologies and virtual reality design methods. Also includes presentation of intelligent railway vehicle development.

  18. After MacIntyre : Kaasaegsest vooruseetikast / Meego Remmel

    Index Scriptorium Estoniae

    Remmel, Meego

    2006-01-01

    Alasdair MacIntyre panus 20. sajandi eetikasse. Tema käsitlus vooruseetikast ja vooruseetilisest perspektiivist, mida on võimalik näha komplekselt, vaadeldes voorust, praktikat, narratiivi ja traditsiooni mõisteid

  19. COMPARASION OF ISOFLURANE AND HALOTHANE ON RECOVERY CHARACTERISTICS IN DAY CARE SURGERY

    Directory of Open Access Journals (Sweden)

    Kewal Krishan

    2014-12-01

    Full Text Available Day Care Surgery conducted under general anaesthesia, largely depends on anaesthetic agents which have shorter duration of action and hence are able to provide rapid recovery. In the present study we intend to compare the recovery profile of the two easily available agents in India i.e. isoflurane and halothane and compare their usefulness in day care surgery. MATERIALS AND METHODS: 50 patients were randomly divided into two groups of 25 each in age group of 18 to 60 years, of either sex, of American Society of Anaesthesiologists (ASA grade I or II undergoing different surgeries of short duration up to half an hour, after proper preoperative screening. In both the groups induction was done with propofol 2 mg/kg. In group I patients, 1.0 Minimum Alveolar Concentration (MAC halothane and in group II 1.0 MAC isoflurane was used for maintenance of general anesthesia along with mixture of oxygen and nitrous oxide in the ratio of 40: 60. Narcotics and anti sialogogues that cross blood brain barrier were avoided, which may interfere with the recovery patterns. Postoperative recovery was divided into two phases and both the groups were compared by means of various clinical tests. RESULT: We found that early recovery following Isoflurane was more rapid compared to Halothane. The psychomotor tests to assess the intermediate recovery also showed the significant difference between the two groups with P value <0.001. More number of patients was able to sit up at half an hour and stand at two hours in the isoflurane group compared to halothane group. CONCLUSION: Isoflurane is a useful and better anesthetic over halothane and offers a clear advantage when used for maintenance of anaesthesia for operations performed on a day-care basis.

  20. Blood-Brain Barrier Disruption Caused by Ultrasound Bursts Combined with Microbubbles Depends on Anesthesia

    Science.gov (United States)

    McDannold, Nathan; Zhang, Yongzhi; Vykhodtseva, Natalia

    2011-09-01

    Prior works on BBB disruption via inter-arterial infusions of osmotic agents have shown a strong dependence on anesthesia. Here, we investigated whether different anesthesia agents can affect ultrasound-induced BBB disruption. A piston transducer fired through a rubber aperture (frequency: 532 kHz, diameter: 4 cm, aperture diameter: 16 mm) was used to generate the ultrasound fields, and sonications combined with an ultrasound contrast agent were performed at 5 power levels. BBB disruption was quantified by measuring the MRI contrast enhancement in T1-weighted MRI, and erythrocyte extravasation characterized in light microscopy. For each exposure level tested, experiments performed with ketamine/xylazine resulted in significantly greater (Panesthesia agent, possibly due effects on the vasculature. These results suggest that care is needed in comparing experiments with different anesthesia agents and physiological factors need to be considered with ultrasound-induced BBB disruption.

  1. Sedation and Anesthesia Options for Pediatric Patients in the Radiation Oncology Suite

    Directory of Open Access Journals (Sweden)

    Eric A. Harris

    2010-01-01

    Full Text Available External beam radiation therapy (XRT has become one of the cornerstones in the management of pediatric oncology cases. While the procedure itself is painless, the anxiety it causes may necessitate the provision of sedation or anesthesia for the patient. This review paper will briefly review the XRT procedure itself so that the anesthesia provider has an understanding of what is occurring during the simulation and treatment phases. We will then examine several currently used regimens for the provision of pediatric sedation in the XRT suite as well as a discussion of when and how general anesthesia should be performed if deemed necessary. Standards of care with respect to patient monitoring will be addressed. We will conclude with a survey of the developing field of radiation-based therapy administered outside of the XRT suite.

  2. [General anesthesia during short operations in patients using the herbal psychogenic stimulant CAT (Catha edulis)].

    Science.gov (United States)

    Nuzeĭli, M; Burov, N E; Marinchev, V N; Khureĭbi, Ia

    2009-01-01

    The specific features of general anesthesia during short inpatient operations were performed in 85 patients who were regular CAT users owing to their national habits. According to the herbal psychogenic stimulant CAT dependence, the patients were divided into 3 groups. The findings indicate that propofol (2 mg/kg) in combination with isoflurane and premedication as diatepam (0.1-0.15 mg/kg) and fentanyl (1 mg/kg) is the anesthesia of choice in all group patients. Ketamine in combination with isoflurane may be used in the controls and Group 1 patients with mild CAT dependence. In patients with moderate and severe CAT dependence, ketamine should be considered to be contraindicated due to the development of adverse psychomotor and somatic reactions requiring monitoring and drug correction in an intensive care unit. The results of the study have been introduced into practice on choosing the modes of anesthesia at the Revolution Hospital, Republic of Yemen. PMID:19824416

  3. Construction of MIMO MAC Codes Achieving the Pigeon Hole Bound

    CERN Document Server

    Ernvall, Toni

    2012-01-01

    This paper provides a general construction method for multiple-input multiple-output multiple access channel codes (MIMO MAC codes) that have so called generalized full rank property. The achieved constructions give a positive answer to the question whether it is generally possible to reach the so called pigeon hole bound, that is an upper bound for the decay of determinants of MIMO-MAC channel codes.

  4. Electronic and Mac Protocol Characterization of RFID Modules

    OpenAIRE

    Nejah, Nasri; Abdennaceur, Kachouri; Laurent, Andrieux; Mounir, Samet

    2010-01-01

    In this chapter we detailed the RFID technology and we making the extraction of pattern from the electronic modules comprising the RFID system (base station and transponder). Finally we presented a comparison study on the MAC layer of the OSI model. Especially we have presented a tree of accesses method for wireless networks and we have modeled CSMA based o MAC protocol for RFID networks in NS2.

  5. On the Development of Low Power MAC Protocol for WBANs

    OpenAIRE

    Sana Ullah; Pervez Khan; Kyung Sup Kwak

    2009-01-01

    Current advances in wireless communication, microelectronics, semiconductor technologies, and intelligent sensors have contributed to the development of unobtrusive WBANs. These networks provide long term health monitoring of patients without any constraint in their normal activities. Traditional MAC protocols do not accommodate the assorted WBAN traffic requirements in a power efficient manner. In this paper, we present a brief discussion on the development process of a low power MAC protoco...

  6. Proposal Of DQRAP/CDMA MAC protocol optimization

    OpenAIRE

    Giovanini, G; Alonso Zárate, Luis Gonzaga; Agustí Comes, Ramon

    2001-01-01

    Future third-generation mobile communication systems will need MAC protocols suitable for multimedia CDMA radio communications. DQRAP/CDMA (distributed queueing random access protocol/CDMA) is a general purpose MAC protocol oriented to the CDMA environment. Analytical model expressions and computer simulations have shown its capacity to achieve near-optimum performance under certain traffic scenarios. Starting from the DQRAP/CDMA specification presented in Alonso et al. (2000), we propose som...

  7. MAC and baseband processors for RF-MIMO WLAN

    OpenAIRE

    Stamenkovic, Zoran; Tittelbach-Helmrich, Klaus; Krstic, Milos; Ibáñez Díaz, Jesús María; Elvira Arregui, Víctor; Santamaría Caballero, Luis Ignacio

    2011-01-01

    The article describes hardware solutions for the IEEE 802.11 medium access control (MAC) layer and IEEE 802.11a digital baseband in an RF-MIMO WLAN transceiver that performs the signal combining in the analogue domain. Architecture and implementation details of the MAC processor including a hardware accelerator and a 16-bit MACphysical layer (PHY) interface are presented. The proposed hardware solution is tested and verified using a PHY link emulator. Architecture, design, implementation, and...

  8. Anaphylaxis due to thiopental sodium anesthesia.

    OpenAIRE

    Dolovich, J; Evans, S.; Rosenbloom, D; Goodacre, R; Rafajac, F O

    1980-01-01

    Anaphylaxis due to an anesthetic is one type of cardiovascular emergency that can occur during general anesthesia. Anaphylactic reactions to muscle relaxants have been documented. Barbiturates, used as sedatives, are well known to produce cutaneous reactions, but anaphylaxis after their ingestion seems to be rare. Generalized allergic reactions to thiopental sodium during anesthesia are mentioned in the product monograph for Penthothal sodium, and rare case reports of anaphylactic reactions t...

  9. Anesthesia Approach in Endovascular Aortic Reconstruction

    Directory of Open Access Journals (Sweden)

    Ayşin Alagöl

    2013-03-01

    Full Text Available Introduction: We have analyzed our initial results of our anesthesia techniques in our new-onset endovascular aortic reconstruction cases.Patients and Methods: The perioperative data of 15 elective and emergent endovascular aortic reconstruction cases that were operated in 2010-2011 were collected in a database. The choice of anesthesia was made by the risk factors, surgical team’s preferences, type and location of the aortic pathology and by the predicted operation duration. The data of local and general anesthesia cases were compared.Results: Thirteen (86.7% cases were male and 2 (13.3% female. Eleven patients were in ASA Class III. The demographic parameters, ASA classifications, concurrent diseases were similar in both groups. Thirteen (86.7% cases had infrarenal abdominal aortic aneurysm and 2 (13.3% had Type III aortic dissection. The diastolic arterial pressures were lower in general anesthesia group in 20th and 40th minutes’ measurements just like the mean arterial pressure measurements at the 40th, 100th minutes and during the deployment of the graft. Postoperative mortality occurred in 3 (20.0% patients and they all had general anesthesia and they were operated on emergency basis. Postoperative morbidity occurred in four patients that had general anesthesia (acute renal failure, multi-organ failure and pneumonia. The other patient had atrial fibrillation on the 1st postoperative day and was converted to sinus rhythm with amiodarone infusion.Conclusion: Edovascular aortic reconstruction procedures can safely be performed with both general and local anesthesia less invasively compared to open surgery. General anesthesia may be preferred for the better hemodynamic control.

  10. Acupuncture assisted local anesthesia for penile surgeries

    OpenAIRE

    Hsu, Geng-Long; Zaid, Uwais X.; Hsieh, Cheng-Hsing; Huang, Sheng-Jean

    2013-01-01

    Although the mechanism of acupuncture for analgesia is not fully elucidated, a combination of acupuncture and several methods of topical blocks for local anesthesia has been effective to patients with indications for penile surgeries on ambulatory basis. We sought to review this unique clinical application since 1998. To summarize practice-based medical literature contingent this unique application and, in contrast, the commonly agreed either general or spinal anesthesia concerning those surg...

  11. Methylphenidate Actively Induces Emergence from General Anesthesia

    OpenAIRE

    Solt, Ken; Cotten, Joseph F.; Cimenser, Aylin; Wong, Kin F.K.; Chemali, Jessica J.; Brown, Emery N.

    2011-01-01

    Background: Although accumulating evidence suggests that arousal pathways in the brain play important roles in emergence from general anesthesia, the roles of monoaminergic arousal circuits are unclear. In this study, the authors tested the hypothesis that methylphenidate (an inhibitor of dopamine and norepinephrine transporters) induces emergence from isoflurane general anesthesia. Methods: Using adult rats, the authors tested the effect of intravenous methylphenidate on time to emergence...

  12. A Patterned Preamble MAC Protocol for Wireless Sensor Networks

    Science.gov (United States)

    Joe, Inwhee

    In this paper, we propose a novel MAC protocol with the patterned preamble technique to improve performance in terms of low power, channel utilization, and delay in wireless sensor networks. B-MAC is one of typical MAC protocols for wireless sensor networks using the duty cycle in order to achieve low-power operation. Since it works in an asynchronous fashion, B-MAC employs extended preamble and preamble sampling techniques. Even if it has outstanding performance in idle state, the overhead of these techniques is very large when packets are sent and received, because there is a lot of waste in the traditional preamble method. Instead of the simple preamble, our proposed MAC solution is to introduce more intelligent preamble with some patterns consisting of 2 phases (Tx phase & Ack phase). With this concept we implement real source code working on the mica2 platform with Tinyos-1.x version. Also, the test setup is presented, and the test results demonstrate that the proposed protocol provides better performance in terms of delay compared to B-MAC.

  13. A Sensing Error Aware MAC Protocol for Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    Donglin Hu

    2012-08-01

    Full Text Available Cognitive radios (CR are intelligent radio devices that can sense the radio environment and adapt to changes in the radio environment. Spectrum sensing and spectrum access are the two key CR functions. In this paper, we present a spectrum sensing error aware MAC protocol for a CR network collocated with multiple primary networks. We explicitly consider both types of sensing errors in the CR MAC design, since such errors are inevitable for practical spectrum sensors and more importantly, such errors could have significant impact on the performance of the CR MAC protocol. Two spectrum sensing polices are presented, with which secondary users collaboratively sense the licensed channels. The sensing policies are then incorporated into p-Persistent CSMA to coordinate opportunistic spectrum access for CR network users.We present an analysis of the interference and throughput performance of the proposed CR MAC, and find the analysis highly accurate in our simulation studies. The proposed sensing error aware CR MAC protocol outperforms two existing approaches with considerable margins in our simulations, which justify the importance of considering spectrum sensing errors in CR MAC design.

  14. Epidural anesthesia in repeated cesarean section.

    Directory of Open Access Journals (Sweden)

    Rolando T. Espín González

    2003-04-01

    Full Text Available Background: A spectacular development has been experimented in the Anesthesiology branch in the last few years in the different areas of its competence in which the attendance activity on obstetric patients as well as every aspect related with its adequate practice is of a great importance. Objective: to evaluate the efficacy of epidural anesthesia in repetitive cesarean. Methods: a descriptive retrospective study of a series of cases (112in which epidural anesthesia in repetitive cesarean was applied from January 2001 to December 2001 in the surgical unit of the Gynecological obstetric service at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ in Cienfuegos city, Cuba. Some variables such as fixation time of the anesthesia, its duration, transurgical and postsurgical hemodynamic behavior, complications related with the anesthesia, evaluation of the new born baby and, the level of satisfaction of the patients were analyzed. Results: The immediate transurgical and postsurgical hemodynamic behavior was stable predominating normotension and the normal cardiac frequency. The complications related to anesthesia were minimal. The level of satisfaction of the patients was elevated. No alterations in new born babies were presented. As a conclusion, it may be stated that epidural anesthesia in repetitive cesarean is a safety and reliable anesthetic method.

  15. High thoracic epidural anesthesia in cardiac surgery: risk factors for arterial hypotension.

    Science.gov (United States)

    Casalino, Stefano; Mangia, Fabio; Stelian, Edmond; Novelli, Eugenio; Diena, Marco; Tesler, Ugo F

    2006-01-01

    There is an interest in the use of high thoracic epidural anesthesia in cardiac surgery, because experimental and clinical studies have suggested that central neuroaxial blockade attenuates the response to surgical stress and improves myocardial metabolism and perioperative analgesia-thus enabling earlier extubation and a smoother postoperative course. Matters of major concern in the adoption of high thoracic epidural anesthesia in cardiac surgery are neurologic injury secondary to neuroaxial hematoma and hypotension secondary to sympatholysis. The risk associated with possible neuraxial hematoma caused by high thoracic epidural anesthesia has been thoroughly investigated and largely discounted, but scant attention has been devoted to the onset of hypotensive episodes in the same setting. We analyzed the hypotensive episodes that occurred in a series of 144 patients who underwent on-pump cardiac surgery procedures. Among the patient variables that we tested in a multivariate logistic-regression model, only female sex was found to be significantly correlated with hypotension. In order to decrease the incidence and severity of hypotensive episodes resulting from anesthetic blockade, anesthesiologists need to monitor, with special care, women patients who are under high thoracic epidural anesthesia. Further studies are needed in order to determine why women undergoing open heart surgery under high thoracic epidural anesthesia are at a relatively greater risk of hypotension. PMID:16878616

  16. [Effects of epidural analgesia combined with general anesthesia on hemodynamics during neck surgery].

    Science.gov (United States)

    Arakawa, M; Amemiya, N; Nagai, K; Kato, S; Goto, F

    1993-10-01

    The aim of the present study was to investigate the effect of epidural analgesia combined with general anesthesia on hemodynamics. Thirty patients undergoing surgery for the treatment of cancer of the neck were studied. The patients were divided into two groups of those who received epidural analgesia combined with general anesthesia group (Group 1) and those with general anesthesia alone (Group 2). Blood pressure was not different between the groups. But heart rate and rate pressure products in Group 1 were significantly lower than those of Group 2. CVP in Group 1 increased significantly to 10.1 +/- 2.9 mmHg during surgery from 6.8 +/- 1.8 mmHg at the beginning of the surgery. There was no difference in intraoperative blood loss and the amount of fluid infused between the two groups. These results suggest that epidural anesthesia combined with general anesthesia is effective to stabilize hemodynamics during cervical surgery, but we have to be careful about using local anesthetics during long cervical procedures, because it increases CVP which might result from the depression of cardiac function. PMID:8230698

  17. Physiological Signal Processing for Individualized Anti-nociception Management During General Anesthesia: A Review

    Science.gov (United States)

    Bonhomme, V.; Jeanne, M.; Boselli, E.; Gruenewald, M.; Logier, R.; Richebé, P.

    2015-01-01

    Summary Objective The aim of this paper is to review existing technologies for the nociception / anti-nociception balance evaluation during surgery under general anesthesia. Methods General anesthesia combines the use of analgesic, hypnotic and muscle-relaxant drugs in order to obtain a correct level of patient non-responsiveness during surgery. During the last decade, great efforts have been deployed in order to find adequate ways to measure how anesthetic drugs affect a patient’s response to surgical nociception. Nowadays, though some monitoring devices allow obtaining information about hypnosis and muscle relaxation, no gold standard exists for the nociception / anti-nociception balance evaluation. Articles from the PubMed literature search engine were reviewed. As this paper focused on surgery under general anesthesia, articles about nociception monitoring on conscious patients, in post-anesthesia care unit or in intensive care unit were not considered. Results In this article, we present a review of existing technologies for the nociception / anti-nociception balance evaluation, which is based in all cases on the analysis of the autonomous nervous system activity. Presented systems, based on sensors and physiological signals processing algorithms, allow studying the patients’ reaction regarding anesthesia and surgery. Conclusion Some technological solutions for nociception / antinociception balance monitoring were described. Though presented devices could constitute efficient solutions for individualized anti-nociception management during general anesthesia, this review of current literature emphasizes the fact that the choice to use one or the other mainly relies on the clinical context and the general purpose of the monitoring. PMID:26293855

  18. Diagnosing & Treating Digestive Tract Disorders Endoscopically

    Medline Plus

    Full Text Available ... either under general anesthesia or under what we call MAC, which is monitored anesthesia care. And that ... it empties through a little nipple that we call the papilla or the ampulla. And we can ...

  19. Learning Unix for Mac OS X Tiger Unlock the Power of Unix

    CERN Document Server

    Taylor, Dave

    2005-01-01

    Thoroughly revised and updated for Mac OS X Tiger, this new edition introduces Mac users to the Terminal application and shows you how to navigate the command interface, explore hundreds of Unix applications that come with the Mac, and, most importantly, how to take advantage of both the Mac and Unix interfaces. If you want to master the command-line, this gentle guide to using Unix on Mac OS X Tiger is well worth its cover price

  20. Design of a Novel Optimized MAC Unit using Modified Fault Tolerant Vedic Multiplier

    OpenAIRE

    Deepa, R.; Shanmugam, A.

    2014-01-01

    In this study, the design of optimized Multiplication and Accumulation (MAC) unit with modified Vedic multiplier is presented. To design a MAC unit, efficient multiplier is used to increase speed and to reduce area and power. Conventional MAC is designed using without fault tolerant Vedic multiplier. But it consumes more area and power. And also less delay. So MAC unit is changed to design the efficient Vedic multiplier. Conventional MAC unit with regular Vedic multiplier is not working for s...

  1. Reductions in anesthesia direct costs is not the right way for racionalization of anesthesia costs

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2012-01-01

    Full Text Available Introduction. Anesthesia management is characterized by salary limiting and pressure for decreasing anesthetics and other drug budget. The aim of this paper is to determine the possibility of reducing the direct costs in anesthesia. Materials and methods. This paper is a part of a five-year (2005-2009, academic, pharmaco-economic retrospective- prospective study (phase IV. The study was done according to European Union Directive for Clinical Research. We retrospectively calculated and analyzed all anesthesia direct costs (personnel costs, anesthetics and other drug costs, materials, laboratory analyses, and machines at the Institute For Ane- sthesia and Reanimation, Clinical Center of Serbia in relation to the costs refunded by National Health Insurance in all patients who underwent anesthesia in 2006. Results. Out of 70 195 anesthesia services rendered to 32 267 patients in one-year period, 47% were general anesthesia, 23% were local anesthesia, and 30% were anesthetic procedures. Our results of highly significant association between personnel costs (r = 0.980, p = 0.000 and consumption of anesthetics and drugs (r = 0.885, p = 0.000 with the direct costs do not provide an opportunity for further cost reduction due to disassociation of direct costs and the ”unit price” of National Health Insurance issued in terms of the restricted maximum budget for health. Conclusion. There is no space for direct cost reduction in anesthesia.

  2. General anesthesia versus segmental thoracic or conventional lumbar spinal anesthesia for patients undergoing laparoscopic cholecystectomy

    OpenAIRE

    Yousef, Gamal T.; Lasheen, Ahmed E.

    2012-01-01

    Background: Laparoscopic cholecystectomy became the standard surgery for gallstone disease because of causing less postoperative pain, respiratory compromise and early ambulation. Objective: This study was designed to compare spinal anesthesia, (segmental thoracic or conventional lumbar) vs the gold standard general anesthesia as three anesthetic techniques for healthy patients scheduled for elective laparoscopic cholecystectomy, evaluating intraoperative parameters, postoperative recovery an...

  3. Victor Bérard et la Macédoine

    Directory of Open Access Journals (Sweden)

    Ivan Savev

    2011-01-01

    Full Text Available Un helléniste convaincu, Victor Bérard, en vient, au début du XXe siècle à soutenir l’existence de « Macédoniens » et le slogan « la Macédoine aux Macédoniens”.Le Congrès de Berlin en 1878 avait laissé la Macédoine aux mains des Ottomans. La Grèce, la Serbie et la Bulgarie, parvenues à ses limites et prévoyant le retrait futur des Ottomans peaufinent les arguments linguistiques et historiques qui justifieront leurs revendications territoriales. Victor Bérard, un helléniste respecté et bon connaisseur de la région sud balkanique, effectue des enquêtes en Macédoine en 1896 et 1903 qu’il publie à Paris.Cette étude montre comment, dans le contexte de la propagande nationaliste des prétendants à la possession de la Macédoine, Victor Bérard en vient progressivement à affirmer qu’il existe une population autochtone, les Macédoniens. Il soutient leur programme pour la constitution d’une fédération ou confédération avec le slogan « la Macédoine aux Macédoniens » ce qui fait toute l’actualité de ses ouvrages.In 1878, the Congress of Berlin had left Macedonia in the hands of the Ottomans. Greece, Serbia and Bulgaria had reached its limits. Anticipating the Ottoman retreat, they polish language and historical arguments that will justify their territorial claims. Victor Bérard, a respected Hellenist and a good expert of the southern Balkans, is doing researches in Macedonia in 1896 and 1903. These will be later published in Paris.This study shows how, in the context of the nationalist propaganda build-up made by the candidates for the possession of Macedonia, Victor Bérard comes progressively to assert the existence of a native population: the Macedonians. He supports their program for the forming of a federation or confederation which slogan would be “Macedonia to Macedonians”. This makes his works very topical.

  4. Minimally invasive parathyroidectomy under local anesthesia

    Directory of Open Access Journals (Sweden)

    Ö Karahan

    2013-01-01

    Full Text Available Background: More than 85% of primary hyperparathyroidism (PHPT cases are due to solitary, benign parathyroid adenomas. Recently, the success rate of Tc99m sestamibi scintigraphy in localization has made minimally invasive parathyroidectomy (MIP more prominent. MIP is as effective as conventional bilateral neck exploration. Moreover, it offers lower morbidity, cost effectiveness, and better cosmetics effects. Aim: We aimed to evaluate the success of MIP, which happens only under local anesthesia, in this study. Materials and Methods: Total of 63 patients were operated for PHPT, of which 54 had solitary adenoma. Five patients underwent bilateral neck exploration under general anesthesia for thyroid nodules or unlocalizated adenomas. A total of 49 patients underwent MIP under local anesthesia without any sedation. During MIP, gamma probe was used for all patients. The patients were followed for parathyroid functions. Results: The mean age of 49 patients with MIP (5 male, 44 female was 59 years. The mean follow-up time was 16.4 (±10.1 months (range: 2-36 months. Of the 49 patients, 47 (96% were totally cured. In 2 patients, the procedure was switched to conventional bilateral neck exploration. Temporary hypocalcaemia was noted in 4 patients. Conclusions: If the adenoma is localizated, MIP under only local anesthesia can be performed with a high success rate. Gamma probe-guided MIP under local anesthesia is an effective and safe method. It has the advantage of being minimally invasive and, therefore, it should be preferred over the conventional method.

  5. Survey of international regional anesthesia fellowship directors

    Directory of Open Access Journals (Sweden)

    Lansdown AK

    2013-07-01

    Full Text Available Andrew K Lansdown,1,2 Paul G McHardy,1 Sanjiv C Patel,1,3 Catherine M Nix,1 Colin JL McCartney1 1Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; 2University of Sydney, Sydney, NSW, Australia; 3University College Hospital, London, UK Background: The scope of regional anesthesia fellowship programs has not been analyzed but may provide insights that could improve fellowship training and standards. Methods: Regional anesthesia fellowship directors across the world were asked to complete a comprehensive survey that detailed the range of educational and practical experience and attitudes as well as assessment procedures offered in their programs. Results: The survey response rate was 66% (45/68. Overall, the range of activities and the time and resources committed to education during fellowships is encouraging. A wide range of nerve block experience is reported with most programs also offering acute pain management, research, and teaching opportunities. Only two-thirds of fellowships provide formal feedback. This feedback is typically a formative assessment. Conclusion: This is the first survey of regional anesthesia fellowship directors, and it illustrates the international scope and continuing expansion of education and training in the field. The results should be of interest to program directors seeking to benchmark and improve their educational programs and to faculty involved in further curriculum development. Keywords: anesthesia, regional, fellowship, education

  6. Cooperative MIMO Transmissions in WSN Using Threshold Based MAC Protocol

    Directory of Open Access Journals (Sweden)

    J. Vidhya

    2010-08-01

    Full Text Available Sensor networks require robust and efficient communication protocols to maximise the network lifetime.Radio irregularity, channel fading and interference results in larger energy consumption and latency forpacket transmission over wireless channel. Cooperative multi-input multi-output (MIMO schemes whenincorporated in wireless senor network (WSN can significantly improve the communicationperformance. An inefficiently designed medium access control (MAC protocol however, may diminishthe performance gains of MIMO operation. Hence, this paper proposes a distributed threshold basedMAC protocol for cooperative MIMO transmissions using space time block codes (STBC. The protocoluses a thresholding scheme that is updated dynamically based on the queue length at the sending node toachieve lesser energy consumption and minimise latency ensuring the stability of transmission queues atthe nodes. STBC and code combining techniques are applied to utilise the inherent spatial diversity inwireless cooperative MIMO systems. Simulation results are provided to evaluate the performance of theproposed protocol and are compared with fixed group size cooperative MIMO MAC protocols with andwithout STBC coding. Results show that the proposed protocol outperforms point to point communicationas well as cooperative MIMO MAC protocols that use fixed group sizes. STBC technique for the proposedMAC protocol provides significant energy savings and minimises the packet delay by leveraging MIMOdiversity gains.

  7. Protocol for the BAG-RECALL clinical trial: a prospective, multi-center, randomized, controlled trial to determine whether a bispectral index-guided protocol is superior to an anesthesia gas-guided protocol in reducing intraoperative awareness with explicit recall in high risk surgical patients

    Directory of Open Access Journals (Sweden)

    Villafranca Alex

    2009-11-01

    Full Text Available Abstract Background Awareness with explicit recall of intra-operative events is a rare and distressing complication that may lead to severe psychological symptoms. Candidate depth of anesthesia monitors have been developed, partly with the aim of preventing this complication. Despite conflicting results from clinical trials and the lack of incisive validation, such monitors have enjoyed widespread clinical adoption, in particular the bispectral index. The American Society of Anesthesiologists has called for adequately powered and rigorously designed clinical trials to determine whether the use of such monitors decreases the incidence of awareness in various settings. The aim of this study is to determine with increased precision whether incorporating the bispectral index into a structured general anesthesia protocol decreases the incidence of awareness with explicit recall among a subset of surgical patients at increased risk for awareness and scheduled to receive an inhalation gas-based general anesthetic. Methods/Design BAG-RECALL is a multi-center, randomized, controlled clinical trial, in which 6,000 patients are being assigned to bispectral index-guided anesthesia (target range, 40 to 60 or end-tidal anesthetic gas-guided anesthesia (target range, 0.7 to 1.3 age-adjusted minimum alveolar concentration. Postoperatively, patients are being assessed for explicit recall at two intervals (0 to 72 hours, and 30 days after extubation. The primary outcome of the trial is awareness with explicit recall. Secondary outcomes include postoperative mortality, psychological symptoms, intensive care and hospital length of stay, average anesthetic gas administration, postoperative pain and nausea and vomiting, duration of stay in the recovery area, intra-operative dreaming, and postoperative delirium. Discussion This trial has been designed to complement two other clinical trials: B-Unaware and MACS (ClinicalTrials.gov numbers, NCT00281489 and NCT00689091

  8. An anesthesia medication cost scorecard--concepts for individualized feedback.

    Science.gov (United States)

    Malapero, Raymond J; Gabriel, Rodney A; Gimlich, Robert; Ehrenfeld, Jesse M; Philip, Beverly K; Bates, David W; Urman, Richard D

    2015-05-01

    There is a growing emphasis on both cost containment and better quality health care. The creation of better methods for alerting providers and their departments to the costs associated with patient care is one tool for improving efficiency. Since anesthetic medications used in the OR setting are one easily monitored factor contributing to OR costs, anesthetic cost report cards can be used to assess the cost and, potentially the quality of care provided by each practitioner. An ongoing challenge is the identification of the most effective strategies to control costs, promote cost awareness and at the same time maximize quality. To test the scorecard concept, we utilized existing informatics systems to gather and analyze drug costs for anesthesia providers in the OR. Drug costs were analyzed by medication class for each provider. Individual anesthesiologist's anesthetic costs were collected and compared to the average costs of the overall group and individual trends over time were noted. We presented drug usage data in an electronic report card format. Real-time individual reports can be provided to anesthesiologists to allow for anesthetic cost feedback. Data provided can include number of cases, average case time, total anesthetic medication costs, and average anesthetic cost per case. Also included can be subcategories of pre-medication, antibiotics, hypnotics, local anesthetics, neuromuscular blocking drugs, analgesics, vasopressors, beta-blockers, anti-emetics, volatile anesthetics, and reversal agents. The concept of anesthetic cost report card should be further developed for individual feedback, and could include many other dimensions. Such a report card can be utilized to encourage lower anesthetic costs, quality improvement among anesthesia providers, and for cost containment in the operating room. PMID:25732076

  9. Pediatric regional anesthesia- A comparison between pediatric spinal and caudal anesthesia

    Directory of Open Access Journals (Sweden)

    Charu Pandya

    2014-01-01

    Full Text Available Regional anesthesia in children was first studied by August Bier in 1899. Since then, spinal anesthesia was known to be practiced for several years with a series of cases published as early as in 1909-1910. (1 In 1900, Bainbridge reported a case of strangulated hernia repair under spinal anesthesia in an infant of three months(2. Thereafter, Tyrell Gray, a British surgeon published a series of 200 cases of lower abdominal surgeries in infants and children under spinal anesthesia in 1909-1910. The appearance of neuromuscular blocking agents and the development of volatile anesthetics in the forties shifted the techniques toward general anesthesia. However, spinal pediatric anesthesia did not disappear. In 1901, Sicard and Cathelin introduced independently the caudal approach in the anesthetic practice. The first publication that mentions this technique in children was written by Campbell in 1933 and the second one by Leigh and Belton in 1951. Subsequently, Fortuna (1963 in Brazil, Melman(10 (1973 in Mexico, Takasaki (1977 in Japan, Ecoffey(7 (1985 in France, and Rash (1995 in USA, introduced these techniques in their countries. The caudal technique is extensively described by Key in 1994. When regional anesthesia is given to older children, some variables such as the intervention site, age, and presence of chronic disease, cooperativeness and parental preferences should be considered. In present study we compared caudal block with spinal block in pediatric patients.

  10. Transient Neurological Symptoms after Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Zehra Hatipoglu

    2013-02-01

    Full Text Available Lidocaine has been used for more than 50 years for spinal anesthesia and has a remarkable safety record. In 1993, a new adverse effect, transient neurologic toxicity was described in patients recovering from spinal anesthesia with lidocaine. Transient neurological symptoms have been defined as pain in the lower extremities (buttocks, thighs and legs after an uncomplicated spinal anesthesia and after an initial full recovery during the immediate postoperative period (less than 24 h. The incidence of transient neurological symptoms reported in prospective, randomized trials varies from 4% to 37%. The etiology of transient neurological symptoms remains unkonwn. Despite the transient nature of this syndrome, it has proven to be difficult to treat effectively. Drug or some interventional therapy may be necessary. [Archives Medical Review Journal 2013; 22(1.000: 33-44

  11. After Anesthesia: The Patient's Active Role Assists in Recovery

    Science.gov (United States)

    ... after—an anesthetic is given. Before anesthesia, a preoperative interview with your anesthesia professional supplies valuable information ... to your mental state as well. Moreover, the anxiety that frequently accompanies important decisions is to be ...

  12. Are Anesthesia Providers Ready for Hypnosis? Anesthesia Providers' Attitudes Toward Hypnotherapy.

    Science.gov (United States)

    Stone, Alexander B; Sheinberg, Rosanne; Bertram, Amanda; Seymour, Anastasia Rowland

    2016-04-01

    This study sought to measure current attitudes toward hypnosis among anesthesia providers using an in-person survey distributed at a single grand rounds at a single academic teaching hospital. One hundred twenty-six anesthesia providers (anesthesiologists and nurse anesthetists) were included in this study. A 10-question Institutional Review Board (IRB)-approved questionnaire was developed. One hundred twenty-six (73% of providers at the meeting) anesthesia providers completed the survey. Of the respondents, 54 (43%) were anesthesiologists, 42 (33%) were trainees (interns/residents/fellows) in anesthesia, and 30 (24%) were nurse anesthetists. Over 70% of providers, at each level of training, rated their knowledge of hypnosis as either below average or having no knowledge. Fifty-two (42%) providers agreed or strongly agreed that hypnotherapy has a place in the clinical practice of anesthesia, while 103 (83%) believed that positive suggestion has a place in the clinical practice of anesthesia (p hypnosis were that it is too time consuming (41%) and requires special training (34%). Only three respondents (2%) believed that there were no reasons for using hypnosis in their practice. These data suggest that there is a self-reported lack of knowledge about hypnosis among anesthesia providers, although many anesthesia providers are open to the use of hypnosis in their clinical practice. Anesthesia providers are more likely to support the use of positive suggestion in their practice than hypnosis. Practical concerns should be addressed if hypnosis and therapeutic verbal techniques are to gain more widespread use. PMID:27003489

  13. Office for iPad and Mac for dummies

    CERN Document Server

    Weverka, Peter

    2015-01-01

    The easy way to work with Office on your iPad or Mac Are you a Mac user who isn't accustomed to working with Microsoft Office? Consider this friendly guide your go-to reference! Written in plain English and packed with easy-to-follow, step-by-step instructions, Office for iPad and Mac For Dummies walks you through every facet of Office, from installing the software and opening files to working with Word, Excel, PowerPoint, and Outlook-and beyond. Plus, you'll discover how to manage files, share content and collaborate online through social media, and find help when you need it. Two things a

  14. SACRB-MAC: A High-Capacity MAC Protocol for Cognitive Radio Sensor Networks in Smart Grid.

    Science.gov (United States)

    Yang, Zhutian; Shi, Zhenguo; Jin, Chunlin

    2016-01-01

    The Cognitive Radio Sensor Network (CRSN) is considered as a viable solution to enhance various aspects of the electric power grid and to realize a smart grid. However, several challenges for CRSNs are generated due to the harsh wireless environment in a smart grid. As a result, throughput and reliability become critical issues. On the other hand, the spectrum aggregation technique is expected to play an important role in CRSNs in a smart grid. By using spectrum aggregation, the throughput of CRSNs can be improved efficiently, so as to address the unique challenges of CRSNs in a smart grid. In this regard, we proposed Spectrum Aggregation Cognitive Receiver-Based MAC (SACRB-MAC), which employs the spectrum aggregation technique to improve the throughput performance of CRSNs in a smart grid. Moreover, SACRB-MAC is a receiver-based MAC protocol, which can provide a good reliability performance. Analytical and simulation results demonstrate that SACRB-MAC is a promising solution for CRSNs in a smart grid. PMID:27043573

  15. Vehicle Health Management Communications Requirements for AeroMACS

    Science.gov (United States)

    Kerczewski, Robert J.; Clements, Donna J.; Apaza, Rafael D.

    2012-01-01

    As the development of standards for the aeronautical mobile airport communications system (AeroMACS) progresses, the process of identifying and quantifying appropriate uses for the system is progressing. In addition to defining important elements of AeroMACS standards, indentifying the systems uses impacts AeroMACS bandwidth requirements. Although an initial 59 MHz spectrum allocation for AeroMACS was established in 2007, the allocation may be inadequate; studies have indicated that 100 MHz or more of spectrum may be required to support airport surface communications. Hence additional spectrum allocations have been proposed. Vehicle health management (VHM) systems, which can produce large volumes of vehicle health data, were not considered in the original bandwidth requirements analyses, and are therefore of interest in supporting proposals for additional AeroMACS spectrum. VHM systems are an emerging development in air vehicle safety, and preliminary estimates of the amount of data that will be produced and transmitted off an aircraft, both in flight and on the ground, have been prepared based on estimates of data produced by on-board vehicle health sensors and initial concepts of data processing approaches. This allowed an initial estimate of VHM data transmission requirements for the airport surface. More recently, vehicle-level systems designed to process and analyze VHM data and draw conclusions on the current state of vehicle health have been undergoing testing and evaluation. These systems make use of vehicle system data that is mostly different from VHM data considered previously for airport surface transmission, and produce processed system outputs that will be also need to be archived, thus generating additional data load for AeroMACS. This paper provides an analysis of airport surface data transmission requirements resulting from the vehicle level reasoning systems, within the context of overall VHM data requirements.

  16. Convulsions during cataract surgery under peribulbar anesthesia: a case report

    OpenAIRE

    Bensghir, Mustapha; Badou, Najlae; Houba, Abdelhafid; Balkhi, Hicham; Haimeur, Charki; Azendour, Hicham

    2014-01-01

    Introduction Locoregional anesthesia techniques are increasingly used for cataract surgery. From these techniques, peribulbar anesthesia has been very successful over the retrobulbar anesthesia seen its effectiveness and safety. However, peribulbar anesthesia is not without risk. Case presentation A 70-year-old African man was scheduled for cataract surgery and lens implant for his right eye. His medical history included hypertension, diabetes mellitus and gall bladder surgery. There were no ...

  17. Phrenic nerve blocage with spinal anesthesia for laparoscopic Nissen fundoplication

    Directory of Open Access Journals (Sweden)

    Murat Dursun

    2015-06-01

    Full Text Available In this case, we describe a patient having laparoscopic Nissen fundoplication (LNF under spinal anesthesia with phrenic nerve blockade. It’s emphasized that in this type of operations, spinal anesthesia may be an alternative method rather the general anesthesia and the resulting shoulder pain in laparoscopic surgery performed under spinal anesthesia can be prevented by phrenic nerve blockade. J Clin Exp Invest 2015; 6 (2: 186-188

  18. Anesthesia for pediatric external beam radiation therapy

    International Nuclear Information System (INIS)

    Background: For very young patients, anesthesia is often required for radiotherapy. This results in multiple exposures to anesthetic agents over a short period of time. We report a consecutive series of children anesthetized for external beam radiation therapy (EBRT). Methods: Five hundred twelve children ≤ 16 years old received EBRT from January 1983 to February 1996. Patient demographics, diagnosis, anesthesia techniques, monitoring, airway management, complications, and outcome were recorded for the patients requiring anesthesia. Results: One hundred twenty-three of the 512 children (24%) required 141 courses of EBRT with anesthesia. Anesthetized patients ranged in age from 20 days to 11 years (mean 2.6 ± 1.8 ). The frequency of a child receiving EBRT and requiring anesthesia by age cohort was: ≤ 1 year (96%), 1-2 years (93%), 2-3 years (80%), 3-4 years (51%), 4-5 years (36%), 5-6 years (13%), 6-7 years (11%), and 7-16 years (0.7%). Diagnoses included: primary CNS tumor (28%), retinoblastoma (27%), neuroblastoma (20%), acute leukemia (9%), rhabdomyosarcoma (6%), and Wilms' tumor (4%). Sixty-three percent of the patients had been exposed to chemotherapy prior to EBRT. The mean number of anesthesia sessions per patient was 22 ± 16. Seventy-eight percent of the treatment courses were once daily and 22% were twice daily. Anesthesia techniques included: short-acting barbiturate induction + inhalation maintenance (21%), inhalation only (20%), ketamine (19%), propofol only (12%), propofol induction + inhalation maintenance (7%), ketamine induction + inhalation maintenance (6%), ketamine or short-acting barbiturate induction + inhalation maintenance (6%). Monitoring techniques included: EKG (95%), O2 saturation (93%), fraction of inspired O2 (57%), and end-tidal CO2 (55%). Sixty-four percent of patients had central venous access. Eleven of the 74 children with a central line developed sepsis (15%): 6 of the 11 were anesthetized with propofol (55%), 4 with a short

  19. Fault Tolerant Wireless Sensor Mac Protocol for Efficient Collision Avoidance

    Directory of Open Access Journals (Sweden)

    Abhishek Samanta

    2010-06-01

    Full Text Available In sensor networks communication by broadcast methods involves many hazards, especially collision.Several MAC layer protocols have been proposed to resolve the problem of collision namely ARBP,where the best achieved success rate is 90%. We hereby propose a MAC protocol which achieves agreater success rate (Success rate is defined as the percentage of delivered packets at the source reachingthe destination successfully by reducing the number of collisions, but by trading off the averagepropagation delay of transmission. Our proposed protocols are also shown to be more energy efficient interms of energy dissipation per message delivery, compared to the currently existing protocol.

  20. Z-MAC an Analytical Model for Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Ramchand V

    2011-12-01

    Full Text Available This paper presents an analytical model for estimat ing throughput and energy consumption in Z-MAC protocol for Wireless Sensor Networks. The analytic al design includes transmission power control and transmission of frames through one hop, two hop and multi hop. Proposed model reduces collision under low contention level as well as high contention lev el with the use of explicit contention notification . The proposed protocol has been simulated using MATLAB. The simulations reveal better results for throughpu t and energy consumption of the proposed model as com pared to Z-MAC protoco

  1. Materiaalivirtojen tehostaminen Mac Steel Oy:ssä

    OpenAIRE

    Toivonen, Mika

    2011-01-01

    Työssä tutkitaan Mac Steel Oy:n materiaalivirta ongelmia, ongelman lähteitä ja keinoja päästä ongelmista eroon. Mac Steelin tuotanto on keskitytty suuriin kappaleisiin, jotka aiheuttavat tietynlaisia ongelmia materiaalien ja valmiiden tuotteiden käsittelyssä. Asiakaskunta on laaja johon kuuluu maamme johtavia alumiiniveneiden ja ajoneuvoteollisuuden yrityksiä, lisäksi tuotteita valmistetaan teräsrakenne teollisuuden tarpeisiin. Lähtökohtana on tutkia Lean ajatusmaailmaa ja sieltä löytää ne...

  2. Alasdair MacIntyre: relatividad conceptual, tomismo y liberalismo

    Directory of Open Access Journals (Sweden)

    Carlos Isler S.

    2011-01-01

    Full Text Available Influenciado por Thomas Kuhn, Alasdair MacIntyre presenta una teoría conceptualmente relativista sobre las tradiciones de investigación, la cual pretende no sólo describir la estructura de las distintas tradiciones, sino también encontrar un principioque permita resolver las disputas entre ellas. Se expone esta teoría y se analiza su compatibilidad con el tomismo, tradición a la que MacIntyre dice pertenecer, y con el liberalismo, tradición a la que critica con vigor.

  3. Beyond MacIntyre: Grounding the business as practice debate

    OpenAIRE

    Kavanagh, Donncha

    2012-01-01

    Alasdair MacIntyre’s distinction between institutions and practices helps illuminate how powerful institutional forces frame and constrain the practice of organizational research as well as the output and positioning of scholarly journals. Yet his conceptual frame is limited, not least because it is unclear whether the activity of managing is, or is not, a practice. This paper builds on MacIntyre’s ideas by incorporating Aristotle’s concepts of poíēsis, praxis, téchnē and ...

  4. Decentralised Learning MACs for Collision-free Access in WLANs

    CERN Document Server

    Fang, Minyu; Duffy, Ken R; Leith, Douglas J

    2010-01-01

    By combining the features of CSMA and TDMA, fully decentralised WLAN MAC schemes have recently been proposed that converge to collision-free schedules. In this paper we describe a MAC with optimal long-run throughput that is almost decentralised. We then design two scheme that are practically realisable, decentralised approximations of this optimal scheme and operate with different amounts of sensing information. We achieve this by (1) introducing learning algorithms that can substantially speed up convergence to collision free operation; (2) developing a decentralised schedule length adaptation scheme that provides long-run fair (uniform) access to the medium while maintaining collision-free access for arbitrary numbers of stations.

  5. Severe tracheobronchial compression in a patient with Turner′s syndrome undergoing repair of a complex aorto-subclavian aneurysm: Anesthesia perspectives

    Directory of Open Access Journals (Sweden)

    Christopher C .C. Hudson

    2014-01-01

    Full Text Available We present a case of severe tracheobronchial compression from a complex aorto-subclavian aneurysm in a patient with Turner′s syndrome undergoing open surgical repair. Significant airway compression is a challenging situation and requires careful preoperative preparation, maintenance of spontaneous breathing when possible, and consideration of having an alternative source of oxygenation and circulation established prior to induction of general anesthesia. Cardiopulmonary monitoring is essential for safe general anesthesia and diagnosis of unexpected intraoperative events.

  6. The Effect of Peribulbar Block with General Anesthesia for Vitreoretinal Surgery in Premature and Ex-Premature Infants with Retinopathy of Prematurity.

    Science.gov (United States)

    Sinha, Renu; Maitra, Souvik

    2016-01-15

    Safe anesthesia in premature and ex-premature infants remains a challenge for the anesthesiologist. These infants are at risk of postoperative apnea, desaturation, and bradycardia after general anesthesia. We describe our experience of peribulbar block in 24 infants who underwent vitreoretinal surgery for retinopathy of prematurity. None of our patients had postoperative apnea or required neonatal intensive care admission. A possible opioid and muscle relaxant-sparing effect of peribulbar block might have reduced the incidence of postoperative complications. PMID:26556110

  7. 21 CFR 868.5240 - Anesthesia breathing circuit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia breathing circuit. 868.5240 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5240 Anesthesia breathing circuit. (a) Identification. An anesthesia breathing circuit is a device that is intended to administer medical gases to...

  8. 21 CFR 868.5170 - Laryngotracheal topical anesthesia applicator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laryngotracheal topical anesthesia applicator. 868... topical anesthesia applicator. (a) Identification. A laryngotracheal topical anesthesia applicator is a device used to apply topical anesthetics to a patient's laryngotracheal area. (b) Classification....

  9. 21 CFR 868.5140 - Anesthesia conduction kit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction kit. 868.5140 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5140 Anesthesia conduction kit. (a) Identification. An anesthesia conduction kit is a device used to administer to a patient conduction, regional,...

  10. 21 CFR 868.5130 - Anesthesia conduction filter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction filter. 868.5130 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5130 Anesthesia conduction filter. (a) Identification. An anesthesia conduction filter is a microporous filter used while administering to a...

  11. 21 CFR 868.5150 - Anesthesia conduction needle.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction needle. 868.5150 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5150 Anesthesia conduction needle. (a) Identification. An anesthesia conduction needle is a device used to inject local anesthetics into a patient...

  12. 21 CFR 868.5120 - Anesthesia conduction catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction catheter. 868.5120 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5120 Anesthesia conduction catheter. (a) Identification. An anesthesia conduction catheter is a flexible tubular device used to...

  13. Effect of general anesthesia and orthopedic surgery on serum tryptase

    DEFF Research Database (Denmark)

    Garvey, Lene H; Bech, Birgitte Louise; Mosbech, Holger;

    2010-01-01

    Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study was to inve...

  14. 21 CFR 884.5100 - Obstetric anesthesia set.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric anesthesia set. 884.5100 Section 884.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5100 Obstetric anesthesia set. (a) Identification. An obstetric anesthesia set is an assembly...

  15. Regional anesthesia for pediatric knee surgery: a review of the indications, procedures, outcomes, safety, and challenges

    Directory of Open Access Journals (Sweden)

    Muhly WT

    2015-11-01

    Full Text Available Wallis T Muhly, Harshad G Gurnaney, Arjunan GaneshDepartment of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, PA, USAAbstract: The indications for surgery on the knee in children and adolescents share some similarity to adult practice in that there are an increasing number of sports-related injuries requiring surgical repair. In addition, there are some unique age-related conditions or congenital abnormalities that may present as indications for orthopedic intervention at the level of the knee. The efficacy and safety of peripheral nerve blocks (PNBs for postoperative analgesia following orthopedic surgery has been well established in adults. Recent studies have also demonstrated earlier functional recovery after surgery in patients who received PNBs. In children, PNB is gaining popularity, and increasing data are emerging to demonstrate the feasibility, efficacy, and safety in this population. In this paper, we will review some of the most common indications for surgery involving the knee in children and the anatomy of knee, associated dermatomal and osteotomal innervation, and the PNBs most commonly used to produce analgesia at the level of the knee. We will review the evidence in support of regional anesthesia in children in terms of both the quality conferred to the immediate postoperative care and the role of continuous PNBs in maintaining effective analgesia following discharge. Also we will discuss some of the subtle challenges in utilizing regional anesthesia in the pediatric patient including the use of general anesthesia when performing regional anesthesia and the issue of monitoring for compartment syndrome. Finally, we will offer some thoughts about areas of practice that are in need of further investigation.Keywords: pediatric surgery, regional anesthesia, analgesia, knee surgery

  16. Directional Medium Access Control (MAC Protocols in Wireless Ad Hoc and Sensor Networks: A Survey

    Directory of Open Access Journals (Sweden)

    David Tung Chong Wong

    2015-06-01

    Full Text Available This survey paper presents the state-of-the-art directional medium access control (MAC protocols in wireless ad hoc and sensor networks (WAHSNs. The key benefits of directional antennas over omni-directional antennas are longer communication range, less multipath interference, more spatial reuse, more secure communications, higher throughput and reduced latency. However, directional antennas lead to single-/multi-channel directional hidden/exposed terminals, deafness and neighborhood, head-of-line blocking, and MAC-layer capture which need to be overcome. Addressing these problems and benefits for directional antennas to MAC protocols leads to many classes of directional MAC protocols in WAHSNs. These classes of directional MAC protocols presented in this survey paper include single-channel, multi-channel, cooperative and cognitive directional MACs. Single-channel directional MAC protocols can be classified as contention-based or non-contention-based or hybrid-based, while multi-channel directional MAC protocols commonly use a common control channel for control packets/tones and one or more data channels for directional data transmissions. Cooperative directional MAC protocols improve throughput in WAHSNs via directional multi-rate/single-relay/multiple-relay/two frequency channels/polarization, while cognitive directional MAC protocols leverage on conventional directional MAC protocols with new twists to address dynamic spectrum access. All of these directional MAC protocols are the pillars for the design of future directional MAC protocols in WAHSNs.

  17. Myocardial protection during off pump coronary artery bypass surgery: A comparison of inhalational anesthesia with sevoflurane or desflurane and total intravenous anesthesia

    Directory of Open Access Journals (Sweden)

    Sharadaprasad Suryaprakash

    2013-01-01

    Full Text Available Aims and Objectives: The objective of the study was to evaluate the myocardial protective effect of volatile agents-sevoflurane and desflurane versus total intravenous anesthesia (TIVA with propofol in offpump coronary artery bypass surgery (OPCAB by measuring cardiac troponin-T (cTnT as a marker of myocardial cell death. Materials and Methods: The study was conducted on 139 patients scheduled to undergo elective OPCAB surgery. The patients were randomly allocated to receive anesthesia with sevoflurane, desflurane or TIVA with propofol. The cTnT levels were measured preoperatively, at arrival in postoperative intensive care unit, at 8, 24, 48 and 96 hours thereafter. Results: The changes in cTnT levels at all time intervals were comparable in the three groups. Conclusion: The study did not reveal any difference in myocardial protection after OPCAB with either sevoflurane or desflurane or TIVA using propofol as assessed by measuring serial cTnT values.

  18. Adopting the American anesthesia oral examination in China: value and roadblocks

    OpenAIRE

    Zhao, J; Yu, W; Tong, C; Xie, Z.; Sun, J.; Zhou, SF; Liu, H; L. Meng

    2016-01-01

    The quality and standardized training and certification of young physicians is key to the quality of health care in the future. In contrast to the American system, there is no nationwide and standardized oral examination in the training and certification process for anesthesiologists in China. The adoptability of the American anesthesia oral examination in China, as well as potential roadblocks, has not been specifically discussed. In this commentary, we share our experience of introducing th...

  19. Does the Maslach Burnout Inventory correlate with cognitive performance in anesthesia practitioners? A pilot study

    OpenAIRE

    Eleonora Francesca Orena; Dario Caldiroli; Paolo Cortellazzi

    2013-01-01

    Background: Chronic stress is a common condition among health-care operators, anesthetists in particular. It is known to cause cognitive weakening and pathological outcomes, as the Burnout syndrome. Nevertheless, the impact of clinicians′ health on their performance has received limited attention thus far. Our pilot study, aims at evaluating the influence of burnout on the cognitive performance in a population of anesthesia practitioners. Methods: In 18 practitioners we assessed attention by ...

  20. [Comparative assessment of inhalation anesthesia with sevofluran and intravenous anesthesia with propofol for carotid endarterectomy].

    Science.gov (United States)

    Neĭmark, M I; Shmelev, V V; Simagin, V Iu

    2009-01-01

    Total intravenous anesthesia with propofol and inhalation sevofluran was assessed in 130 patients with carotid endarterectomy. The parameters of brain blood circulation, brain damage markers were studied. It was shown that sevofluran anesthesia caused less depression of the hemodynamic parameters, supported more optimum level of brain blood flow that limited ischemic and reperfusion damage of the brain and was accompanied by a fewer number of postoperative complications. PMID:20209996

  1. Regional anesthesia for trauma patients

    OpenAIRE

    TONKOVIĆ, DINKO; NESEK ADAM, VIŠNJA; BARONICA, ROBERT; BANDIĆ PAVLOVIĆ, DANIJELA; DRVAR, ŽELJKO; Zah Bogović, Tajana

    2013-01-01

    Trauma patients demands special medical care. Pain is frequently undertreated in the early phase of trauma. Pain is a major symptom of surgical conditions and minimizing pain could lead to misdiagnoses and technical facilities are not appropriate for adequate pain treatment. Consequences of inappropriate pain treatment could aggravate stress response, increases oxygen demand and led to myocardial ischemia Analgesia with parenteral opioids is effective but carries a risk of respiratory depr...

  2. The Biochemical Impact of Surgery and Anesthesia

    NARCIS (Netherlands)

    J.W. Hol (Jaap Willem)

    2014-01-01

    markdownabstract__Abstract__ General anesthesia has been considered by some medical historians as one of the most important contributions to modern medicine second to perhaps the concept of antiseptic medicine and hygiene. The first historical mention of a deep unnatural sleep so that surgery can t

  3. 42 CFR 415.178 - Anesthesia services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Anesthesia services. 415.178 Section 415.178 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING...

  4. Testing haptic sensations for spinal anesthesia.

    LENUS (Irish Health Repository)

    2011-01-01

    Having identified key determinants of teaching and learning spinal anesthesia, it was necessary to characterize and render the haptic sensations (feeling of touch) associated with needle insertion in the lower back. The approach used is to match recreated sensations (eg, "pop" through skin or dura mater) with experts\\' perceptions of the equivalent clinical events.

  5. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    2010-01-01

    With a growing aging population, more patients suffering from dementia are expected to undergo surgery, thus being exposed to either general or regional anesthesia. This calls for specific attention ranging from the legal aspects of obtaining informed consent in demented patients to deciding on the...

  6. Update on complications in pediatric anesthesia

    Directory of Open Access Journals (Sweden)

    Giovanni de Francisci

    2013-02-01

    Full Text Available Complications in pediatric anesthesia can happen, even in our modern hospitals with the most advanced equipment and skilled anesthesiologists. It is important, albeit in a tranquil and reassuring way, to inform parents of the possibility of complications and, in general, of the anesthetic risks. This is especially imperative when speaking to the parents of children who will be operated on for minor procedures: in our experience, they tend to think that the anesthesia will be a light anesthesia without risks. Often the surgeons tell them that the operation is very simple without stressing the fact that it will be done under general anesthesia which is identical to the one we give for major operations. Different is the scenario for the parents of children who are affected by malignant neoplasms: in these cases they already know that the illness is serious. They have this tremendous burden and we choose not to add another one by discussing anesthetic risks, so we usually go along with the examination of the child without bringing up the possibility of complications, unless there is some specific problem such as a mediastinal mass.

  7. [Anesthesia in the Signal Processing Methods].

    Science.gov (United States)

    Gu, Jiajun; Huang, Yan; Ye, Jilun; Wang, Kaijun; Zhang, Meimei

    2015-09-01

    Anesthesia plays an essential role in clinical operations. Guiding anesthesia by EEG signals is one of the most promising methods at present and it has obtained good results. The analysis and process of the EEG signals in anesthesia can provide clean signal for further research. This paper used variance threshold method to remove the mutation fast and large interfering signals; and used notch filter to remove frequency interference, smoothing filter to remove baseline drift and Butterworth low-pass filter to remove high frequency noise at the same time. In addition to this, the translation invariant wavelet method to remove interference noise on the signals which was after the classical filter and retained non-stationary characteristics was used to evaluate parameter calculation. By comparing the calculated parameters from treated signal using this paper's methods and untreated signal and standard signal, the standard deviation and correlation has been improved, particularly the major parameters BetaR, which provides better signal for integration of multi-parameter to evaluate depth of anesthesia index for the latter. PMID:26904870

  8. Respiratory Monitoring for Anesthesia and Sedation

    OpenAIRE

    Anderson, Jay A.

    1987-01-01

    This article reviews the theory and practice of routine respiratory monitoring during anesthesia and sedation. Oxygen monitoring and capnography methods are reviewed. The current ventilation monitoring system of choice is considered a combination of the pulse oximeter and capnography. Guidelines are provided for monitoring standards.

  9. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    With a growing aging population, more patients suffering from dementia are expected to undergo surgery, thus being exposed to either general or regional anesthesia. This calls for specific attention ranging from the legal aspects of obtaining informed consent in demented patients to deciding on the...

  10. RE-MAC: A Reliable Energy Efficient MAC Protocol For Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Santhosh Simon

    2013-03-01

    Full Text Available Wireless sensor networks are considered to be a promising area to equip scientists with the capability of developing real-time monitoring systems. This paper discusses the design and development of a wireless sensor network (WSN that can be used for monitoring purposes in the agricultural fields. This battery-powered sensor node makes the network deployment easy but limit the lifetime of the network to the limited capacity of these batteries. The main source of energy wastage in modern sensor networks is idle listening and overhearing. Duty cycling is a proven mechanism to overcome the energy wastage through idle listening. In this paper we introduce a new MAC protocol named as REMAC that minimizes the idle listening by allowing nodes to remain in sleep state until it is necessary to wakeup. It also allows the participating nodes to wake up during the sleep time, perform the data transfer and return to sleep state thereby minimizing the chances for over hearing. We show the performance of REMAC through detailed simulations in NS-2 and also compare the performance evaluation with similar synchronous protocols that employ duty cycling. In the analysis REMAC proves to be saving much energy as compared to others.

  11. A Wavelet Transform Based Method to Determine Depth of Anesthesia to Prevent Awareness during General Anesthesia

    Directory of Open Access Journals (Sweden)

    Seyed Mortaza Mousavi

    2014-01-01

    Full Text Available Awareness during general anesthesia for its serious psychological effects on patients and some juristically problems for anesthetists has been an important challenge during past decades. Monitoring depth of anesthesia is a fundamental solution to this problem. The induction of anesthesia alters frequency and mean of amplitudes of the electroencephalogram (EEG, and its phase couplings. We analyzed EEG changes for phase coupling between delta and alpha subbands using a new algorithm for depth of general anesthesia measurement based on complex wavelet transform (CWT in patients anesthetized by Propofol. Entropy and histogram of modulated signals were calculated by taking bispectral index (BIS values as reference. Entropies corresponding to different BIS intervals using Mann-Whitney U test showed that they had different continuous distributions. The results demonstrated that there is a phase coupling between 3 and 4 Hz in delta and 8-9 Hz in alpha subbands and these changes are shown better at the channel T7 of EEG. Moreover, when BIS values increase, the entropy value of modulated signal also increases and vice versa. In addition, measuring phase coupling between delta and alpha subbands of EEG signals through continuous CWT analysis reveals the depth of anesthesia level. As a result, awareness during anesthesia can be prevented.

  12. Comparison of Anesthesia Quality for Arthroscopic Knee Surgery: Combined Sciatic Femoral Block and Unilateral Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Sinem Sarı

    2015-08-01

    Full Text Available Objective: We aimed to evaluate the quality of anesthesia of combined sciatic and femoral 3-in-1 nerve blocks (CSFB and unilateral spinal anesthesia technique with low-dose levobupivacaine in outpatients undergoing knee arthroscopy surgery. Materials and Methods: Forty American Society of Anesthesiologists (ASA physical status I-II patients were randomly allocated into two groups and unilateral spinal anesthesia with low-dose levobupivacaine (group S, n=20 or CSFB (group B, n=20 was performed. Besides the quality of anesthesia, anesthetic effectiveness, hemodynamic values, duration of the technique application, maximum motor and sensorial block levels and durations, the first analgesics need, and total analgesic consumptions during postoperative 24 hours and determined complications were compared between the two groups. Results: The quality of anesthesia was better in group S, no patient received either sedation or analgesic intraoperatively while first analgesic need and number of patient was higher (p=0.014, p<0.001, p=0.032 respectively. The duration of technical application was shorter while maximum motor and sensorial block levels were higher in group S (p<0.0001, p=0.008, p<0.001 respectively. Motor block duration was significantly longer in group B (p<0.0001. Conclusion: We concluded that CSFB practice is an effective anesthetic alternative for unilateral spinal anesthesia. Introduction

  13. MAC mini acceptance test procedures, software Version 3.3

    International Nuclear Information System (INIS)

    The K Basins Materials Accounting (MAC) programs had some improvements made to it to to change slightly the access authorized users had to the modification of critical data. This ATP describes how the code was to be tested to verify its correctness

  14. Cooperative MIMO Transmissions in WSN Using Threshold Based MAC Protocol

    OpenAIRE

    Vidhya, J.; Dananjayan, P.

    2010-01-01

    Sensor networks require robust and efficient communication protocols to maximise the network lifetime.Radio irregularity, channel fading and interference results in larger energy consumption and latency forpacket transmission over wireless channel. Cooperative multi-input multi-output (MIMO) schemes whenincorporated in wireless senor network (WSN) can significantly improve the communicationperformance. An inefficiently designed medium access control (MAC) protocol however, may diminishthe per...

  15. MacDowell-Mansouri gravity and Cartan geometry

    International Nuclear Information System (INIS)

    The geometric content of the MacDowell-Mansouri formulation of general relativity is best understood in terms of Cartan geometry. In particular, Cartan geometry gives clear geometric meaning to the MacDowell-Mansouri trick of combining the Levi-Civita connection and coframe field, or soldering form, into a single physical field. The Cartan perspective allows us to view physical spacetime as tangentially approximated by an arbitrary homogeneous 'model spacetime', including not only the flat Minkowski model, as is implicitly used in standard general relativity, but also de Sitter, anti-de Sitter or other models. A 'Cartan connection' gives a prescription for parallel transport from one 'tangent model spacetime' to another, along any path, giving a natural interpretation of the MacDowell-Mansouri connection as 'rolling' the model spacetime along physical spacetime. I explain Cartan geometry, and 'Cartan gauge theory', in which the gauge field is replaced by a Cartan connection. In particular, I discuss MacDowell-Mansouri gravity, as well as its more recent reformulation in terms of BF theory, in the context of Cartan connections.

  16. Mechatronical Aided Concept (MAC in Intelligent Transport Vehicles Design

    Directory of Open Access Journals (Sweden)

    Pavel Pavlasek

    2003-01-01

    Full Text Available This article deals with the principles of synergy effect of mechatronical aided concept (MAC to the design of intelligent transport vehicles products applying CA technologies and virtual reality design methods. Also includes presentation of intelligent railway vehicle development.

  17. Distributed MAC Protocol Supporting Physical-Layer Network Coding

    CERN Document Server

    Wang, Shiqiang; Wang, Xingwei; Jamalipour, Abbas

    2011-01-01

    Physical-layer network coding (PNC) is a promising approach for wireless networks. It allows nodes to transmit simultaneously. Due to the difficulties of scheduling simultaneous transmissions, existing works on PNC are based on simplified medium access control (MAC) protocols, which are not applicable to general multi-hop wireless networks, to the best of our knowledge. In this paper, we propose a distributed MAC protocol that supports PNC in multi-hop wireless networks. The proposed MAC protocol is based on the carrier sense multiple access (CSMA) strategy and can be regarded as an extension to the IEEE 802.11 MAC protocol. In the proposed protocol, each node collects information on the queue status of its neighboring nodes. When a node finds that there is an opportunity for some of its neighbors to perform PNC, it notifies its corresponding neighboring nodes and initiates the process of packet exchange using PNC, with the node itself as a relay. During the packet exchange process, the relay also works as a ...

  18. God, Sport Philosophy, Kinesiology: A MacIntyrean Examination

    Science.gov (United States)

    Twietmeyer, Gregg

    2015-01-01

    Sport philosophy is in crisis. This subdiscipline of kinesiology garners little to no respect and few tenure track lines in kinesiology departments. Why is this the case? Why isn't philosophy held in greater esteem? Is it possible that philosopher Alasdair MacIntyre's (2009) diagnosis found in "God, Philosophy, Universities" could…

  19. Simulation for a New Real-time Ethernet MAC Protocol

    Institute of Scientific and Technical Information of China (English)

    Shen Gang(沈钢); Cai Yunze; Xu Xiaoming; He Xing; Zhang Weidong

    2004-01-01

    A method for modeling broadcast protocols in OPNET is introduced by illustrating a simulation of a new real-time Ethernet MAC protocol. The details of network models in OPNET are given and the procedure in modeling is introduced. Simulation results verify that the protocol is correct and efficient.

  20. Effects of anesthesia on the cerebral capillary blood flow in young and old mice

    Science.gov (United States)

    Moeini, Mohammad; Tabatabaei, Maryam S.; Bélanger, Samuel; Avti, Pramod; Castonguay, Alexandre; Pouliot, Philippe; Lesage, Frédéric

    2015-03-01

    Despite recent findings on the possible role of age-related cerebral microvasculature changes in cognition decline, previous studies of capillary blood flow in aging (using animal models) are scarce and limited to anesthetized conditions. Since anesthesia can have different effects in young and old animals, it may introduce a confounding effect in aging studies. The present study aimed to eliminate the potential confound introduced by anesthesia by measuring capillary blood flow parameters in both awake conditions and under isoflurane anesthesia. We used 2-photon laser scanning fluorescence microscopy to measure capillary diameter, red blood cell velocity and flux, hematocrit and capillary volumetric flow in individual capillaries in the barrel cortex of 6- and 24-month old C57Bl/6 mice. It was observed that microvascular properties are significantly affected by anesthesia leading to different trends in capillary blood flow parameters with aging when measured under awake or anesthetized conditions. The findings in this study suggest taking extra care in interpreting aging studies from anesthetized animals.

  1. Regional anesthesia for pediatric knee surgery: a review of the indications, procedures, outcomes, safety, and challenges

    Science.gov (United States)

    Muhly, Wallis T; Gurnaney, Harshad G; Ganesh, Arjunan

    2015-01-01

    The indications for surgery on the knee in children and adolescents share some similarity to adult practice in that there are an increasing number of sports-related injuries requiring surgical repair. In addition, there are some unique age-related conditions or congenital abnormalities that may present as indications for orthopedic intervention at the level of the knee. The efficacy and safety of peripheral nerve blocks (PNBs) for postoperative analgesia following orthopedic surgery has been well established in adults. Recent studies have also demonstrated earlier functional recovery after surgery in patients who received PNBs. In children, PNB is gaining popularity, and increasing data are emerging to demonstrate the feasibility, efficacy, and safety in this population. In this paper, we will review some of the most common indications for surgery involving the knee in children and the anatomy of knee, associated dermatomal and osteotomal innervation, and the PNBs most commonly used to produce analgesia at the level of the knee. We will review the evidence in support of regional anesthesia in children in terms of both the quality conferred to the immediate postoperative care and the role of continuous PNBs in maintaining effective analgesia following discharge. Also we will discuss some of the subtle challenges in utilizing regional anesthesia in the pediatric patient including the use of general anesthesia when performing regional anesthesia and the issue of monitoring for compartment syndrome. Finally, we will offer some thoughts about areas of practice that are in need of further investigation. PMID:26609245

  2. Orbital Tumors Excision without Bony Marginotomy under Local and General Anesthesia

    Directory of Open Access Journals (Sweden)

    Robert A. Goldberg

    2014-01-01

    Full Text Available To present our experience of removing middle to deep orbital tumors using a combination of minimally invasive soft tissue approaches, sometimes under local anesthesia. Methods. In this retrospective case series, 30 patients (13 males and 17 females underwent tumor removal through eyelid crease (17 eyes, conjunctival (nine eyes, lateral canthal (two eyes, and transcaruncular (two eyes approaches. All tumors were located in the posterior half of the orbit. Six cases were removed under monitored anesthesia care with local block, and 24 were under general anesthesia. Results. The median (range age and follow-up duration were 48.5 (31–87 years old and 24.5 (4–375 weeks, respectively. Visual acuity and ocular motility showed improvement or no significant change in all but one patient at the latest followup. Confirmed pathologies revealed cavernous hemangioma (15 cases, pleomorphic adenoma (5 cases, solitary fibrous tumor (4 cases, neurofibroma (2 cases, schwannoma (2 cases, and orbital varix (1 case. None of the patients experienced recurrence. Conclusions. Creating a bony marginotomy increases intraoperative exposure of the deep orbit but adds substantial time and morbidity. Benign orbital tumors can often be removed safely through small soft-tissue incisions, without bone removal and under local anesthesia.

  3. Safe spinal anesthesia in a woman with chronic renal failure and placenta previa

    Directory of Open Access Journals (Sweden)

    Beyazit Zencirci

    2010-05-01

    Full Text Available Beyazit ZencirciKahramanmaras, TurkeyBackground: Chronic renal failure is strongly associated with poor pregnancy outcome. Women dependent on hemodialysis before conception rarely achieve a successful live birth.Case presentation: A 31-year-old multiparous Turkish woman was scheduled for cesarean section under spinal anesthesia at 37 weeks and five days’ gestation because of hemorrhage due to secondary placenta previa. Spinal anesthesia with 8 mg of hyperbaric bupivacaine was successfully performed. Invasive blood pressure, central venous pressure, and heart rate were stable during the surgery. The mother returned to regular hemodialysis on the first postoperative day.Conclusion: Pregnancy is uncommon in women with chronic renal failure requiring chronic dialysis. Rates of maternal hypertension, pre-eclampsia, anemia, and infection in the pregnant chronic dialysis patient are high. However, our findings suggest that with careful, close, and effective monitoring preoperatively and intraoperatively, spinal anesthesia can be safely performed for cesarean section in patients undergoing hemodialysis.Keywords: chronic renal failure, pregnancy, spinal anesthesia, hemodialysis, placenta previa

  4. Chest CT in children: anesthesia and atelectasis

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Gawande, Rakhee [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Krane, Elliot J. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA (United States); Holmes, Tyson H. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Robinson, Terry E. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary Biology, Stanford, CA (United States)

    2014-02-15

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  5. Chest CT in children: anesthesia and atelectasis

    International Nuclear Information System (INIS)

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  6. The rise of empirical research in medical ethics: a MacIntyrean critique and proposal.

    Science.gov (United States)

    Lawrence, Ryan E; Curlin, Farr A

    2011-04-01

    Hume's is/ought distinction has long limited the role of empirical research in ethics, saying that data about what something is cannot yield conclusions about the way things ought to be. However, interest in empirical research in ethics has been growing despite this countervailing principle. We attribute some of this increased interest to a conceptual breakdown of the is/ought distinction. MacIntyre, in reviewing the history of the is/ought distinction, argues that is and ought are not strictly separate realms but exist in a close relationship that is clarified by adopting a teleological orientation. We propose that, instead of recovering a teleological orientation, society tends to generate its own goals via democratic methods like those described by Rousseau or adopt agnosticism about teleology such as described by Richard Rorty. In both latter scenarios, the distinction between is and ought is obscured, and the role for empirical research grows, but for controversial reasons. MacIntyre warns that the is/ought distinction should remain, but reminds ethicists to make careful arguments about when and why it is legitimate to move from is to ought. PMID:21339390

  7. An Energy-Efficient MAC Protocol for Medical Emergency Monitoring Body Sensor Networks.

    Science.gov (United States)

    Zhang, Chongqing; Wang, Yinglong; Liang, Yongquan; Shu, Minglei; Chen, Changfang

    2016-01-01

    Medical emergency monitoring body sensor networks (BSNs) monitor the occurrence of medical emergencies and are helpful for the daily care of the elderly and chronically ill people. Such BSNs are characterized by rare traffic when there is no emergency occurring, high real-time and reliable requirements of emergency data and demand for a fast wake-up mechanism for waking up all nodes when an emergency happens. A beacon-enabled MAC protocol is specially designed to meet the demands of medical emergency monitoring BSNs. The rarity of traffic is exploited to improve energy efficiency. By adopting a long superframe structure to avoid unnecessary beacons and allocating most of the superframe to be inactive periods, the duty cycle is reduced to an extremely low level to save energy. Short active time slots are interposed into the superframe and shared by all of the nodes to deliver the emergency data in a low-delay and reliable way to meet the real-time and reliable requirements. The interposition slots can also be used by the coordinator to broadcast network demands to wake-up all nodes in a low-delay and energy-efficient way. Experiments display that the proposed MAC protocol works well in BSNs with low emergency data traffic. PMID:26999145

  8. An Energy-Efficient MAC Protocol for Medical Emergency Monitoring Body Sensor Networks

    Science.gov (United States)

    Zhang, Chongqing; Wang, Yinglong; Liang, Yongquan; Shu, Minglei; Chen, Changfang

    2016-01-01

    Medical emergency monitoring body sensor networks (BSNs) monitor the occurrence of medical emergencies and are helpful for the daily care of the elderly and chronically ill people. Such BSNs are characterized by rare traffic when there is no emergency occurring, high real-time and reliable requirements of emergency data and demand for a fast wake-up mechanism for waking up all nodes when an emergency happens. A beacon-enabled MAC protocol is specially designed to meet the demands of medical emergency monitoring BSNs. The rarity of traffic is exploited to improve energy efficiency. By adopting a long superframe structure to avoid unnecessary beacons and allocating most of the superframe to be inactive periods, the duty cycle is reduced to an extremely low level to save energy. Short active time slots are interposed into the superframe and shared by all of the nodes to deliver the emergency data in a low-delay and reliable way to meet the real-time and reliable requirements. The interposition slots can also be used by the coordinator to broadcast network demands to wake-up all nodes in a low-delay and energy-efficient way. Experiments display that the proposed MAC protocol works well in BSNs with low emergency data traffic. PMID:26999145

  9. AWARENESS ABOUT ANESTHESIA AND ANESTHESIOLOGIST AM ONG THE PARAMEDICAL STAFFS OF S N MEDICAL COLLEGE, BAGALKOT (KARNATAKA

    Directory of Open Access Journals (Sweden)

    Hiremath

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : The more advancing and life saving specialty and specialist i.e ., anesthesia and ane sthesiologists, both have been kept behind the screen, more so in developing countries. Though the role of anesthesiologist is crucial, the public knowledge of anesthetic practice is limited. The present day anesthesiologist is based on the use of newer a nd safer drugs, better patient monitoring, pain management, labour analgesia and critical care. OBJECTIVES : This study was designed to assess the knowledge about the role of anesthesia and anesthesiologist among the paramedical staff at S.N medical college , Bagalkot. METHODOLOGY : This prospective questionnaire based study was done at S.N medical college and hospital among paramedical staffs working in different departments after taking the consent and approval of the ethical committee. Data was collected by pretested and predesigned questionnaire from 105 study participants. A majority of 90.28% of respondents felt that anesthesia was necessary for surgery. 40.80% knew that it was given by anesthesiologists. 18.38% of respondents knew that besides anaestheti zing, anesthesiologists monitor the vital signs till the completion of surgery. 5.60%, 9.11% & 3.8% of respondents were aware of their role in ICU, labor analgesia and pain clinic respectively. Only 22.81% patients had knowledge about anesthesia risks give n in consent form. The statistical association between past exposure to anesthesia and knowledge about anesthesia was not significant (p <0.1 . CONCLUSION : Anesthesiologist work mainly in the operation theatre and to some extent monitor the patient in the post operative ward for pain management and nausea vomiting, headache, etc. The role inside the theater & expanding role outside the theater poorly known. The awareness about the role of anesthesiologist in operation theater intensive care unit labor analg esia acute and chronic pain management and emergency care areas and

  10. Role of intraseptal anesthesia for pain-free dental treatment

    Directory of Open Access Journals (Sweden)

    G Gazal

    2016-01-01

    Full Text Available Pain control during the dental procedure is essentials and challenging. A complete efficacious pulp anesthesia has not been attained yet. The regional anesthesia such as inferior alveolar nerve block (IANB only does not guarantee the effective anesthesia with patients suffering from irreversible pulpitis. This main aim of this review was to discuss various aspects of intraseptal dental anesthesia and its role significance in pain-free treatment in the dental office. In addition, reasons of failure and limitations of this technique have been highlighted. Literature search was conducted for peer-reviewed articles published in English language in last 30 years. Search words such as dental anesthesia, pain control, intraseptal, and nerve block were entered using a web of knowledge and Google scholar databases. Various dental local anesthesia techniques were reviewed. A combination of block anesthesia, buccal infiltration and intraligamentary injection resulted in deep anesthesia (P = 0.003, and higher success rate compared to IANB. For pain-free management of conditions such as irreversible pulpitis, buccal infiltration (4% articaine, and intraosseous injection (2% lidocaine are better than intraligamentary and IANB injections. Similarly, nerve block is not always effective for pain-free root canal treatment hence, needing supplemental anesthesia. Intraseptal anesthesia is an efficient and effective technique that can be used in maxillary and mandibular adult dentition. This technique is also beneficial when used in conjunction to the regional block or local dental anesthesia.

  11. Role of intraseptal anesthesia for pain-free dental treatment.

    Science.gov (United States)

    Gazal, G; Fareed, W M; Zafar, M S

    2016-01-01

    Pain control during the dental procedure is essentials and challenging. A complete efficacious pulp anesthesia has not been attained yet. The regional anesthesia such as inferior alveolar nerve block (IANB) only does not guarantee the effective anesthesia with patients suffering from irreversible pulpitis. This main aim of this review was to discuss various aspects of intraseptal dental anesthesia and its role significance in pain-free treatment in the dental office. In addition, reasons of failure and limitations of this technique have been highlighted. Literature search was conducted for peer-reviewed articles published in English language in last 30 years. Search words such as dental anesthesia, pain control, intraseptal, and nerve block were entered using a web of knowledge and Google scholar databases. Various dental local anesthesia techniques were reviewed. A combination of block anesthesia, buccal infiltration and intraligamentary injection resulted in deep anesthesia (P = 0.003), and higher success rate compared to IANB. For pain-free management of conditions such as irreversible pulpitis, buccal infiltration (4% articaine), and intraosseous injection (2% lidocaine) are better than intraligamentary and IANB injections. Similarly, nerve block is not always effective for pain-free root canal treatment hence, needing supplemental anesthesia. Intraseptal anesthesia is an efficient and effective technique that can be used in maxillary and mandibular adult dentition. This technique is also beneficial when used in conjunction to the regional block or local dental anesthesia. PMID:26955316

  12. 78 FR 65541 - Federal Agricultural Mortgage Corporation Funding and Fiscal Affairs; Farmer Mac Liquidity...

    Science.gov (United States)

    2013-11-01

    ... 75 FR 27951 (May 19, 2010). \\12\\ See 76 FR 71798 supra. By a letter dated April 17, 2013, Farmer Mac... detail in the proposed rule imposes the FCA's business judgments on Farmer Mac's board. \\22\\ See 76 FR... change, pending the adoption of final liquidity rules for Farmer Mac. See 77 FR 66375, supra at...

  13. Design of an autonomous decentralized MAC protocol for wireless sensor networks

    OpenAIRE

    Hoesel, van, CPM Stan; Dal Pont, L.; Havinga, P.J.M.

    2003-01-01

    In this document the design of a MAC protocol for wireless sensor networks is discussed. The autonomous decentralized TDMA based MAC protocol minimizes power consumtion by efficiency implementing unicast/omnicast, scheduled rendezvous times and wakeup calls. The MAC protocol is an ongoing research topic in the European research project EYES.

  14. CoR-MAC: Contention over Reservation MAC Protocol for Time-Critical Services in Wireless Body Area Sensor Networks

    Science.gov (United States)

    Yu, Jeongseok; Park, Laihyuk; Park, Junho; Cho, Sungrae; Keum, Changsup

    2016-01-01

    Reserving time slots for urgent data, such as life-critical information, seems to be very attractive to guarantee their deadline requirements in wireless body area sensor networks (WBASNs). On the other hand, this reservation imposes a negative impact on performance for the utilization of a channel. This paper proposes a new channel access scheme referred to as the contention over reservation MAC (CoR-MAC) protocol for time-critical services in wireless body area sensor networks. CoR-MAC uses the dual reservation; if the reserved time slots are known to be vacant, other nodes can access the time slots by contention-based reservation to maximize the utilization of a channel and decrease the delay of the data. To measure the effectiveness of the proposed scheme against IEEE 802.15.4 and IEEE 802.15.6, we evaluated their performances with various performance indexes. The CoR-MAC showed 50% to 850% performance improvement in terms of the delay of urgent and time-critical data according to the number of nodes. PMID:27171085

  15. CoR-MAC: Contention over Reservation MAC Protocol for Time-Critical Services in Wireless Body Area Sensor Networks.

    Science.gov (United States)

    Yu, Jeongseok; Park, Laihyuk; Park, Junho; Cho, Sungrae; Keum, Changsup

    2016-01-01

    Reserving time slots for urgent data, such as life-critical information, seems to be very attractive to guarantee their deadline requirements in wireless body area sensor networks (WBASNs). On the other hand, this reservation imposes a negative impact on performance for the utilization of a channel. This paper proposes a new channel access scheme referred to as the contention over reservation MAC (CoR-MAC) protocol for time-critical services in wireless body area sensor networks. CoR-MAC uses the dual reservation; if the reserved time slots are known to be vacant, other nodes can access the time slots by contention-based reservation to maximize the utilization of a channel and decrease the delay of the data. To measure the effectiveness of the proposed scheme against IEEE 802.15.4 and IEEE 802.15.6, we evaluated their performances with various performance indexes. The CoR-MAC showed 50% to 850% performance improvement in terms of the delay of urgent and time-critical data according to the number of nodes. PMID:27171085

  16. A SIMULATION-BASED PERFORMANCE COMPARISON OF MANETS CDS CREATION ALGORITHMS USING IDEAL MAC AND IEEE 802.11 MAC

    Directory of Open Access Journals (Sweden)

    Khalid A. Almahorg

    2013-11-01

    Full Text Available Mobile Ad Hoc networks (MANETs are gaining increased interest due to their wide range of potential applications in civilian and military sectors. The self-control, self-organization, topology dynamism, and bandwidth limitation of the wireless communication channel make implementation of MANETs a challenging task. The Connected Dominating Set (CDS has been proposed to facilitate MANETs realization. Minimizing the CDS size has several advantages; however, this minimization is NP complete problem; therefore, approximation algorithms are used to tackle this problem. The fastest CDS creation algorithm is Wu and Li algorithm; however, it generates a relatively high signaling overhead. Utilizing the location information of network members reduces the signaling overhead of Wu and Li algorithm. In this paper, we compare the performance of Wu and Li algorithm with its Location-Information-Based version under two types of Medium Access Control protocols, and several network sizes. The MAC protocols used are: a virtual ideal MAC protocol, and the IEEE 802.11 MAC protocol. The use of a virtual ideal MAC enables us to investigate how the real-world performance of these algorithms deviates from their ideal-conditions counterpart. The simulator used in this research is the ns-2 network simulator.

  17. Rocuronium anesthesia induced anaphylactic shock:a case report%罗库溴铵致过敏性休克1例

    Institute of Scientific and Technical Information of China (English)

    邱敏; 宗亚楠; 卢剑; 马潞林; 郑清; 郭向阳

    2015-01-01

    SUMMARY Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen , and it could be an unpre-dictable and life-threatening cause during anesthesia .The main purpose of this paper is to report a case of anaphy-lactic shock during the anesthesia induction and to review the prophylaxis and treatment of anaphylactic reactions and anaphylactoid reactions during the anesthesia period .A 63-year-old man, with a mass on his adrenal , was scheduled to a laparoscopic adrenal tumor excision .During the anesthesia induction period , after administrated sul-fentanil, propofol and rocuronium , the blood pressure was decreased and the heart rate was increased .Then, the patient had rash on his whole body and developed an anaphylactic shock .After being treated with the anti-allergic agents and norepinephrine , the rash disappeared and the vital sign become stable .The patient felt nothing uncom-fortable during the two weeks ’ follow-up.Anaphylactic reactions and anaphylactoid reactions are not rare during the anesthesia period .The most common inducements are muscle relaxant , latex and antibiotics .Anaphylactic reac-tions in the perioperative period are often serious and potentially life-threatening conditions , involving multiple or-gan systems in which the clinical manifestations are the consequence of the release of preformed mediators from mast cells and basophils .Before anesthesia , we should acquire the allergic history .During the anesthesia period , the vi-tal sign and the skin should be observed carefully .

  18. Anesthesiologists Are Affiliated with Many Hospitals Only Reporting Anesthesia Claims Using Modifier QZ for Medicare Claims in 2013.

    Science.gov (United States)

    Miller, Thomas R; Abouleish, Amr; Halzack, Nicholas M

    2016-04-01

    We examined hospitals that exclusively used the billing modifier QZ in anesthesia claims for a 5% sample of Medicare beneficiaries in 2013. We used a national Medicare provider file to identify physician anesthesiologists and nurse anesthetists affiliated with these hospitals. Among the 538 hospitals that exclusively reported the modifier QZ, 47.5% had affiliated physician anesthesiologists. These hospitals accounted for 60.4% of the cases. Our results illustrate the challenges of using modifier QZ to describe anesthesia practice arrangements in hospitals. The modifier QZ does not seem to be a valid surrogate for no anesthesiologist being involved in the care provided. PMID:26491838

  19. ESTRATEGIA ANESTÉSICA PARA LA CIRUGÍA CON EL CORAZÓN LATIENDO. CINCO AÑOS DE EXPERIENCIA EN EL CARDIOCENTRO ERNESTO CHE GUEVARA / Anesthesia strategy for surgery with beating heart. Five years of experience at the “Ernesto Che Guevara” Cardiology Hospital

    Directory of Open Access Journals (Sweden)

    Ignacio R. Fajardo Egozcue

    2009-06-01

    Full Text Available Introduction and Objectives: The anesthesia in coronary surgery, using high sustained doses of fentanyl, leads to protracted postoperative extubation and stay. The assessment of an anesthesiastrategy for coronary surgery without extracorporeal circulation, in order to reduce the use of opioids and make possible an early extubation and a shorter post-surgical stay, was the objective of thiswork. Methods: 732 patients who underwent surgical myocardial revascularization without heartlung machine, from February 2003 to December 2007, using general anesthesia with intermittent boluses of fentanyl, with or without associated epidural anesthesia, were studied. Results: 625 surgical operations with general anesthesia in boluses and 107 adding peridural anesthesia were carried out. The average amount of fentanyl was 34.7 ml per patient in the first group and 24.9 ml when adding peridural anesthesia. Twenty seven patients were extubated in the operating room. The total average time was 8.6 hours (8.8 hours in the group where the anesthesia in boluses wasused and 6.7 hours for those with peridural anesthesia associated. The total average stay at the Intensive Care Unit was 40.1 hours. Conclusions: The intermittent anesthesia reduced the amount of fentanyl used in 86.6 percent when compared to the high sustained doses reported in a previous study. This made possible the early extubation of the patients, which increased due to the use of peridural anesthesia, and a decrease in average stay of the patient at the Intensive Care Unit.

  20. Differential Postoperative Effects of Volatile Anesthesia and Intraoperative Remifentanil Infusion in 7511 Thyroidectomy Patients: A Propensity Score Matching Analysis.

    Science.gov (United States)

    Jo, Jun-Young; Choi, Seong-Soo; Yi, Jung Min; Joo, Eun Young; Kim, Ji Hyun; Park, Se Ung; Sim, Ji-Hoon; Karm, Myong-Hwan; Ku, Seungwoo

    2016-02-01

    Although remifentanil is used widely by many clinicians during general anesthesia, there are recent evidences of opioid-induced hyperalgesia as an adverse effect. This study aimed to determine if intraoperative remifentanil infusion caused increased pain during the postoperative period in patients who underwent a thyroidectomy. A total of 7511 patients aged ≥ 20 years, who underwent thyroidectomy between January 2009 and December 2013 at the Asan Medical Center were retrospectively analyzed. Enrolled patients were divided into 2 groups: group N (no intraoperative remifentanil and only volatile maintenance anesthesia) and group R (intraoperative remifentanil infusion including total intravenous anesthesia and balanced anesthesia). Following propensity score matching analysis, 2582 patients were included in each group. Pain scores based on numeric rating scales (NRS) were compared between the 2 groups at the postoperative anesthetic care unit and at the ward until 3 days postoperation. Incidences of postoperative complications, such as nausea, itching, and shivering were also compared. The estimated NRS pain score on the day of surgery was 5.08 (95% confidence interval [CI] 4.97-5.19) in group N patients and 6.73 (95% CI 6.65-6.80) in group R patients (P < 0.001). There were no statistically significant differences in NRS scores on postoperative days 1, 2, and 3 between the 2 groups. Postoperative nausea was less frequent in group R (31.4%) than in group N (53.5%) (P < 0.001). However, the incidence of itching was higher in group R (4.3%) than in group N (0.7%) (P < 0.001). Continuous infusion of remifentanil during general anesthesia can cause higher intensity of postoperative pain and more frequent itching than general anesthesia without remifentanil infusion immediately after thyroidectomy. Considering the advantages and disadvantages of continuous remifentanil infusion, volatile anesthesia without opioid may be a good choice for minor surgeries

  1. The Superconvergence Phenomenon and Proof of the MAC Scheme for the Stokes Equations on Non-uniform Rectangular Meshes

    KAUST Repository

    Li, Jichun

    2014-12-02

    For decades, the widely used finite difference method on staggered grids, also known as the marker and cell (MAC) method, has been one of the simplest and most effective numerical schemes for solving the Stokes equations and Navier–Stokes equations. Its superconvergence on uniform meshes has been observed by Nicolaides (SIAM J Numer Anal 29(6):1579–1591, 1992), but the rigorous proof is never given. Its behavior on non-uniform grids is not well studied, since most publications only consider uniform grids. In this work, we develop the MAC scheme on non-uniform rectangular meshes, and for the first time we theoretically prove that the superconvergence phenomenon (i.e., second order convergence in the (Formula presented.) norm for both velocity and pressure) holds true for the MAC method on non-uniform rectangular meshes. With a careful and accurate analysis of various sources of errors, we observe that even though the local truncation errors are only first order in terms of mesh size, the global errors after summation are second order due to the amazing cancellation of local errors. This observation leads to the elegant superconvergence analysis even with non-uniform meshes. Numerical results are given to verify our theoretical analysis.

  2. Factors impacting same-day cancellation of outpatient pediatric magnetic resonance imaging under anesthesia

    International Nuclear Information System (INIS)

    Studies of elective surgical procedures indicate that cancellation is common and preventable. Little is known about cancellation of anesthesia-supported elective diagnostic imaging. To describe the reasons for same-day cancellation of MRI studies performed under sedation or anesthesia and identify patient characteristics associated with cancellations. This case-control study was carried out in a university-affiliated tertiary care children's hospital. Cases were defined as elective outpatient MRI studies booked under anesthesia that were cancelled after the patient had arrived in the radiology department in 2009. Matched controls were identified by selecting the same day and time 1 week before or after the cancelled case. Main outcome measures included demographics, MRI study characteristics, and social and medical factors. There were 111 outpatient anesthesia-supported MRI studies cancelled on the same day as the assessment (cancellation rate: 4.5%), of which 74.6% were related to family and patient factors, while 22% were related to system factors. Cancelled cases involved patients who lived in lower median income quintile neighborhoods compared to controls (2 vs. 3; P = 0.0007; odds ratio [OR] 3.81; 95% confidence interval [CI] 1.18-12.34). Those who traveled a greater median distance (in kilometers) were less likely to be cancelled (18.8 vs. 27.1, P = 0.0035). Although cancelled patients had a lower mean number of total medical services (2.5 vs. 3.0; P = 0.03; OR = 0.78; 95% CI 0.62-0.98), current medical factors (past 12 months) did not impact cancellations. Same-day cancellations of anesthesia-supported MRI studies are not uncommon, and the main predictor of cancellation seems to be socioeconomic rather than medical. (orig.)

  3. Factors impacting same-day cancellation of outpatient pediatric magnetic resonance imaging under anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, Andrea S. [University of Toronto, Department of Paediatrics, Division of Developmental Paediatrics, Holland Bloorview Kids Rehabilitation Hospital, Toronto (Canada); Matlow, Anne [University of Toronto, Strategic Initiatives, Postgraduate Medical Education, Toronto (Canada); Shroff, Manohar [University of Toronto, Department of Diagnostic Imaging, Division of Neuroradiology, Hospital for Sick Children, Toronto (Canada); Cohen, Eyal [University of Toronto, Division of Paediatric Medicine and Child Health Evaluative Sciences, Hospital for Sick Children, Department of Paediatrics and Institute of Health Policy, Management and Evaluation, Toronto (Canada)

    2014-07-24

    Studies of elective surgical procedures indicate that cancellation is common and preventable. Little is known about cancellation of anesthesia-supported elective diagnostic imaging. To describe the reasons for same-day cancellation of MRI studies performed under sedation or anesthesia and identify patient characteristics associated with cancellations. This case-control study was carried out in a university-affiliated tertiary care children's hospital. Cases were defined as elective outpatient MRI studies booked under anesthesia that were cancelled after the patient had arrived in the radiology department in 2009. Matched controls were identified by selecting the same day and time 1 week before or after the cancelled case. Main outcome measures included demographics, MRI study characteristics, and social and medical factors. There were 111 outpatient anesthesia-supported MRI studies cancelled on the same day as the assessment (cancellation rate: 4.5%), of which 74.6% were related to family and patient factors, while 22% were related to system factors. Cancelled cases involved patients who lived in lower median income quintile neighborhoods compared to controls (2 vs. 3; P = 0.0007; odds ratio [OR] 3.81; 95% confidence interval [CI] 1.18-12.34). Those who traveled a greater median distance (in kilometers) were less likely to be cancelled (18.8 vs. 27.1, P = 0.0035). Although cancelled patients had a lower mean number of total medical services (2.5 vs. 3.0; P = 0.03; OR = 0.78; 95% CI 0.62-0.98), current medical factors (past 12 months) did not impact cancellations. Same-day cancellations of anesthesia-supported MRI studies are not uncommon, and the main predictor of cancellation seems to be socioeconomic rather than medical. (orig.)

  4. Mac OS X Snow Leopard for Power Users Advanced Capabilities and Techniques

    CERN Document Server

    Granneman, Scott

    2010-01-01

    Mac OS X Snow Leopard for Power Users: Advanced Capabilities and Techniques is for Mac OS X users who want to go beyond the obvious, the standard, and the easy. If want to dig deeper into Mac OS X and maximize your skills and productivity using the world's slickest and most elegant operating system, then this is the book for you. Written by Scott Granneman, an experienced teacher, developer, and consultant, Mac OS X for Power Users helps you push Mac OS X to the max, unveiling advanced techniques and options that you may have not known even existed. Create custom workflows and apps with Automa

  5. Use of Airtraq, C-Mac, and Glidescope laryngoscope is better than Macintosh in novice medical students′ hands: A manikin study

    Directory of Open Access Journals (Sweden)

    Abdullah M Kaki

    2011-01-01

    Full Text Available Background and Aim: Obtaining patent airway is a crucial task for many physicians. When opportunities to practice intubations on patients are really limited, skill gaining methods are needed. We conducted a study among novice 6 th year medical students to assess their ability to intubate the trachea in normal airway in manikin using four airway tools. Setting and Design: Prospective, cohort study conducted at simulation center of university-based, tertiary care hospital. Methods: Fifty medical students performed either oral or nasal tracheal intubation using the following four intubating tools: C-Mac videolaryngoscope, Glidescope, and Airtraq in comparison with regular Macintosh laryngoscope. Intubation time, visualization of glottic opening, ease of intubation, satisfaction of participants, incidence of dental trauma, and the need for optimization manoeuvres′ use among different airway tools were recorded. Results: In oral intubation, Airtraq was better than others in regard to intubation time, glottic opening, ease of intubation, and the need for external laryngeal pressure application, followed by Glidescope, C-Mac, and finally Macintosh laryngoscope ( P<0.001. Airtraq and Glidescope associated with less dental trauma than C-Mac and Macintosh. In nasal route, fastest intubation time was reported with Airtraq followed by Glidescope, C-Mac, and lastly Macintosh. Airtraq, Glidescope, and C-Mac were similar to each other and better than the Macintosh in regard to ease of intubation, satisfaction, and number of attempts (P≤0.008. Conclusions: New devices like Airtraq, Glidescope, and C-Mac are better than the regular Macintosh when used by novice medical students for oral and nasal intubation on manikin.

  6. Anesthesia for cesarean section in pregnancies complicated by placenta previa

    International Nuclear Information System (INIS)

    Objective was to evaluate the factors affecting the choice of anesthetic technique for cesarean section in women with placenta previa. In this retrospective study, the records of the labor Ward Theatre of the University of Benin Teaching Hospital, Benin City, Nigeria were examined from January 2000 to December 2004 to identify all the women who had cesarean section for placenta previa. The patient's socio-demographic characteristics, type of placenta previa, anesthesia technique, estimated blood loss, maternal and fetal outcomes were recorded. One hundred and twenty-six patients had cesarean section for placenta previa, however, only 81 patients 64.3% were available for analysis. General anesthesia was administered to 52/81 patients 64.2% and 29/81 patients 35.8% received spinal anesthesia. A history of antepartum bleeding was recorded in 61.7% n=50. Of 31 patients without antepartum hemorrhage APH, 15/31 had general anesthesia and 16/31 had spinal anesthesia. The patients who had APH, 37/50 had general anesthesia and 1/50 had spinal anesthesia. There was an increased chance of using general anesthesia and if APH were present p=0.03, odds ratio=3.1, 95% confidence interval=1.2-7.7. Spinal anesthesia may useful in patients with placenta previa. The presence of APH may encourage the use of general anesthesia for cesarean delivery. (author)

  7. The comparison of anesthesia effect of lung surgery through video-assisted thoracic surgery: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Jing-Dong Ke

    2015-01-01

    Conclusion: These results indicated that epidural anesthesia can save operating time and postoperative hospital stay time. But epidural anesthesia and general anesthesia have the same effect on complications.

  8. General anesthesia plus ilioinguinal nerve block versus spinal anesthesia for ambulatory inguinal herniorrhapy

    Directory of Open Access Journals (Sweden)

    Lucía Vizcaíno-Martínez

    2014-01-01

    Full Text Available Objective: The aim was to evaluate general anesthesia (GA plus ilioinguinal nerve block (IIB versus spinal anesthesia (SA in patients scheduled for ambulatory inguinal hernia repair regarding pain management, anesthesia recovery and reducing potential complications. Materials and Methods: A double-blind, prospective, randomized, controlled study in patients American Society of Anesthesiologists I-III randomized into two groups: GA plus IIB group, induction of anesthesia with propofol, maintenance with sevoflurane, airway management with laryngeal mask allowing spontaneous ventilation and ultrasound-guided IIB; SA group, patients who underwent spinal block with 2% mepivacaine. The study variables were pain intensity, assessed by visual analog scale, analgesic requirements until hospital discharge, time to ambulation and discharge, postoperative complications-related to both techniques and satisfaction experienced. Results: Thirty-two patients were enrolled; 16 patients in each group. The differences regarding pain were statistically significant at 2 h of admission (P < 0.001 and at discharge (P < 0.001 in favor of the GA plus ilioinguinal block group. In addition in this group, analgesic requirements were lower than SA group (P < 0.001, with times of ambulation and discharge significantly shorter. The SA group had a higher tendency to develop complications and less satisfaction. Conclusion: General anesthesia plus IIB is better than SA regarding postoperative analgesia, time to mobilization and discharge, side-effect profile and satisfaction experienced by the patients.

  9. Clinical Experience of Total Intravenous Anesthesia in 77 Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Pinar Ergenoglu

    2013-08-01

    Full Text Available Purpose:Renal transplantation significantly improves quality of life compared to hemodialysis in patients with end-stage renal failure. In end-stage renal failure anesthetic technique should be planned carefully, due to changes in volume distribution, drug metabolism, excretion. Results of total intravenous anesthesia, inhalation anesthesia, regional techniques are being investigated. Aim of this study was to present our experience in total intravenous anesthesia in 77 patients, who underwent live and cadaveric donor renal transplantation at Baskent University Faculty of Medicine Adana Teaching and Research Center. Material and Methods:Induction of anesthesia was performed with propofol(2mg/kg and fentanyl(1μg/kg, and rocuronium bromide(0.4-0.5mg/kg was given before intubation. Anesthesia was maintained with total intravenous anesthesia(propofol,50 mcg/kg/min; remifentanil,0.25 mcg/kg/min infusion. Intraoperative fluid, urine volumes were recorded. For preemptive multimodal analgesia, pre-incisional intravenous paracetamol(15mg/kg, intramuscular morphine(0.1mg/kg were given. Postoperative analgesia was maintained with intravenous patient-controlled analgesia(meperidine 10 mg bolus, with a lockout time of 20 minutes. Postoperative pain was recorded using Visual Analogue Scale, level of sedation was assessed by Ramsey Sedation Scale. Results:Study included 64(83.1% live donor transplantations and 13(16.9% cadaveric donor transplantations. Mean total fluid administration was similar between live and cadaveric donor kidney transplantation patients however mean intraoperative urine output was significantly higher in live donor kidney transplantation patients(p<0.001. 57.1% of patients had no pain at 5. minutes postoperatively(Visual Analog Scale Score=0, at 15. minutes postoperatively mean visual analog scale score was 2.6 and the first analgesic requirements were recorded at 39.6 minutes. According to Ramsey Sedation Scale, majority of patients(54

  10. Acupuncture in ambulatory anesthesia: a review

    OpenAIRE

    Norheim AJ; Liodden I; Alræk T

    2015-01-01

    Arne Johan Norheim,1 Ingrid Liodden,1 Terje Alræk1,2 1National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, 2The Norwegian School of Health Sciences, Institute of Acupuncture, Kristiania University College, Oslo, NorwayBackground: Post-anesthetic morbidities remain challenging in our daily practice of anesthesia. Meta-an...

  11. A Computerized Record System for Anesthesia Services

    OpenAIRE

    Chase, Christopher R.; Merz, Barbara A.

    1982-01-01

    We have developed a computerized record system, the CAPE system, which supports patient management, administrative and research applications for anesthesia services in our hospital, the Medical Center Hospital of Vermont. In this paper we briefly describe the CAPE system and, as an example of its use in our hospital, we describe the development and implementation of a preoperative screening program used to identify patients at high risk to postoperative respiratory complications.

  12. Assessment of propofol anesthesia in the rabbit

    OpenAIRE

    Campos, Sónia Patrícia Seabra

    2010-01-01

    The growing interests in propofol as an intravenous anesthetic agent and in particular to its use in rabbits were the motivation for this work. The rabbit is the third most common pet, and is also used as a biomedical research model in a wide range of science branches such as pharmacology, toxicology, anesthesiology and surgery. The main goal of this study was to explore the effects of Total Intravenous Anesthesia (TIVA) with propofol in rabbits. Different infusion rates were administrated...

  13. Anesthesia management for MitraClip device implantation

    Directory of Open Access Journals (Sweden)

    Harikrishnan Kothandan

    2014-01-01

    Full Text Available Aims and Objectives: Percutaneous MitraClip implantation has been demonstrated as an alternative procedure in high-risk patients with symptomatic severe mitral regurgitation (MR who are not suitable (or denied mitral valve repair/replacement due to excessive co morbidity. The MitraClip implantation was performed under general anesthesia and with 3-dimensional transesophageal echocardiography (TEE and fluoroscopic guidance. Materials and Methods: Peri-operative patient data were extracted from the electronic and paper medical records of 21 patients who underwent MitraClip implantations. Results: Four MitraClip implantation were performed in the catheterization laboratory; remaining 17 were performed in the hybrid operating theatre. In 2 patients, procedure was aborted, in one due to migration of the Chiari network into the left atrium and in second one, the leaflets and chords of the mitral valve torn during clipping resulting in consideration for open surgery. In the remaining 19 patients, MitraClip was implanted and the patients showed acute reduction of severe MR to mild-moderate MR. All the patients had invasive blood pressure monitoring and the initial six patients had central venous catheterization prior to the procedure. Intravenous heparin was administered after the guiding catheter was introduced through the inter-atrial septum and activated clotting time was maintained beyond 250 s throughout the procedure. Protamine was administered at the end of the procedure. All the patients were monitored in the intensive care unit after the procedure. Conclusions: Percutaneous MitraClip implantation is a feasible alternative in high-risk patients with symptomatic severe MR. Anesthesia management requirements are similar to open surgical mitral valve repair or replacement. TEE plays a vital role during the MitraClip implantation.

  14. [Chronic pain and regional anesthesia in children].

    Science.gov (United States)

    Dadure, C; Marec, P; Veyckemans, F; Beloeil, H

    2013-10-01

    Chronic pain is usually underestimated in children, due to lack of knowledge and its specific signs. In addition to suffering, chronic pain causes a physical, psychological, emotional, social, and financial burden for the child and his family. Practitioners may find themselves in a situation of failure with depletion of medical resources. Some types of chronic pain are refractory to conventional systemic treatment and may require the use of regional anesthesia. Cancer pain is common in children and its medical management is sometimes insufficient. It is accessible to neuroaxial or peripheral techniques of regional anesthesia if it is limited to an area accessible to one of these techniques and no contraindications (e.g., thrombopenia) are present. Complex regional pain syndrome 1 is not rare in children and adolescents, but it often goes undiagnosed. Regional anesthesia may contribute to the treatment of complex regional pain syndrome 1, mainly in case of recurrence, because it provides rapid effective analgesia and allows rapid implementation of intensive physiotherapy. These techniques have also shown interest in phantom limb pain after limb amputation, but they remain controversial for erythromelalgia pain or chronic abdominopelvic pain. Finally, the treatment of postdural puncture headache due to cerebrospinal fluid leak can be treated by performing an epidural injection of the patient's blood, called a blood-patch. Finally, the management of children with chronic pain should be multidisciplinary (pediatrician, physiotherapist, psychologist, surgeon, anesthesiologist) to support the child and her problem in its entirety. PMID:23953871

  15. On the Development of Low Power MAC Protocol for WBANs

    CERN Document Server

    Ullah, Sana; Kwak, Kyung Sup

    2009-01-01

    Current advances in wireless communication, microelectronics, semiconductor technologies, and intelligent sensors have contributed to the development of unobtrusive WBANs. These networks provide long term health monitoring of patients without any constraint in their normal activities. Traditional MAC protocols do not accommodate the assorted WBAN traffic requirements in a power efficient manner. In this paper, we present a brief discussion on the development process of a low power MAC protocol for WBANs. We observe the behavior of a beacon-enabled IEEE 802.15.4 for on-body sensor networks. We further propose a low power technique called traffic based wakeup mechanism for a WBAN that exploits the traffic patterns of the BAN Nodes to ensure power efficient and reliable communication.

  16. ENERGY EFFICIENT MAC PROTOCOLS FOR WIRELESS SENSOR NETWORKS: A SURVEY

    Directory of Open Access Journals (Sweden)

    Bhavana Narain

    2011-09-01

    Full Text Available Use of Wireless sensor networks have been widely seen in the fields of target detection and tracking,environmental monitoring, industrial process monitoring, and tactical systems.In wireless sensornetworks nodes work with a incomplete power source, energy efficient operations in an important factorof the nodes in wireless sensor network. Energy conservation plays important role in different layers ofthe TCP/IP protocol suit, and for MAC layer it is the effective part. Therefore, to work in wirelesscommunicating sensors network, we use MAC protocol which improve energy efficiency by increasingsleep duration, decreasing idle listening and overhearing, and eliminating hidden terminal problem orcollision of packets. In this paper First section we describe the accessible energy –efficient MACprotocols for sensor networks their energy saving method. In Second section we discuss the architectureof same protocols and then compare same protocols depending on their Advantages and Disadvantages

  17. Activity Modelling and Comparative Evaluation of WSN MAC Security Attacks

    DEFF Research Database (Denmark)

    Pawar, Pranav M.; Nielsen, Rasmus Hjorth; Prasad, Neeli R.;

    2012-01-01

    Applications of wireless sensor networks (WSNs) are growing tremendously in the domains of habitat, tele-health, industry monitoring, vehicular networks, home automation and agriculture. This trend is a strong motivation for malicious users to increase their focus on WSNs and to develop...... and initiate security attacks that disturb the normal functioning of the network in a severe manner. Such attacks affect the performance of the network by increasing the energy consumption, by reducing throughput and by inducing long delays. Of all existing WSN attacks, MAC layer attacks are considered....... The second aim of the paper is to simulate these attacks on hybrid MAC mechanisms, which shows the performance degradation of aWSN under the considered attacks. The modelling and implementation of the security attacks give an actual view of the network which can be useful in further investigating secure...

  18. EL CERRO DE POTOSÍ Y EL DIOS PACHACÁMAC THE CERRO DE POTOSÍ AND THE PACHACÁMAC GOD

    Directory of Open Access Journals (Sweden)

    Teresa Gisbert

    2010-06-01

    Full Text Available En este trabajo se plantea que el Cerro de Potosí se ocultó a los españoles por ser el santuario más importante de la región, el cual estaba dedicado al dios Pachacámac. Los testimonios que indican que el cerro de Potosí era "Apu" (Cerro o Señor adorado son abundantes, pero es el cronista Arzans de Orsúa y Vela (año 1736 quien dice que este "Apu" pertenecía a Pachacámac, dios del mundo subterráneo. Una tradición recogida cerca del salar de Uyuni dice lo mismo; finalmente un sacrificio realizado en el siglo XVI a orillas del lago Titicaca en honor a Pachacámac, muestra la presencia de este dios en el Collasuyo. Cuando los incas llegaron a Potosí introdujeron el culto al Sol y cuando llegaron los españoles identificaron el cerro con la Virgen María la cual, a su vez, se identificó con la Pachamama o Madre Tierra.In this essay it is argued that "Cerro de Potosf' was hidden from the Spanish conquerors because it was the region's most important huaca or sanctuary, due to the fact that it was dedicated to the god Pachacámac. Abundant testimonies (colonial documents indicate that "Cerro de Potosf was a worshipped "Apu" (Mountain, Señor or Lord, nevertheless chronicler Orzans de Orsúa y Vela (1736 stated that this "Apu" belonged to Pachacámac, god of the underworld. A tradition collected near the Salar de Uyuni states the same; finally, a sacrifice in honor of Pachacámac that occurred during the 16th century on the shores of Lake Titicaca, shows the presence of this god in the Collasuyo. When the Incas reached Potosí, they introduced worship of the Sun, and when the Spanish conquerors arrived, they identified the "Cerro de Potosf with the Virgin Mary which at the same time was identified with Pachamama or Mother Earth.

  19. ITER management advisory committee (MAC) meeting in Naka

    International Nuclear Information System (INIS)

    The ITER Management Advisory Committee (MAC) Meeting was held on 28 June 2000 in Moskow, Russia. The main topics were the consideration of the report by the director on the ITER EDA status, the review of the work program, the review of the joint fund, the review of a schedule of ITER meetings and initial discussion and consideration on the disposition of R and D hardware and facilities and other dispositions relating to the termination of the EDA

  20. Energy harvesting aware hybrid MAC protocol for WBANs

    OpenAIRE

    Ibarra, Ernesto; Antonopoulos, Angelos; KARTSAKLI, Elli; Verikoukis, Christos

    2013-01-01

    In this paper, we propose a hybrid polling Medium Access Control (MAC) protocol with Human Energy Harvesting capabilities, called HEH-BMAC, designed for Wireless Body Area Networks (WBANs). The proposed protocol uses a dynamic schedule algorithm to combine User Identification polling (ID) and Probabilistic Contention (PC) random access, adapting the network operation to the random, time-varying nature of the human energy harvesting sources. HEH-BMAC offers different levels of node priorities ...

  1. Tournament MAC with Constant Size Congestion Window for WLAN

    OpenAIRE

    Galtier, Jérôme

    2007-01-01

    In the context of radio distributed networks, we present a generalized approach for the Medium Access Control (MAC) with fixed congestion window. Our protocol is quite simple to analyze and can be used in a lot of different situations. We give mathematical evidence showing that our performance is tight, in the sense that no protocol with fixed congestion window can do better. We also place ourselves in the WiFi/WiMAX framework, and show experimental results enlightening collision reduction of...

  2. An Efficient MAC Protocol for WLAN based on OFDM modulation

    Science.gov (United States)

    Michelini, Marco; Fantacci, Romano; Giacomelli, Marco

    2002-11-01

    We propose and analyze a MAC protocol aptly designed for WLAN, based on OFDM modulation. The goal of the analysis is to provide an efficient tool to deliver to voice and data terminals acceptable QoS connections, overcoming the problem of large number of retransmissions, high delays and low reliability. Simulation results show that, in a real environment, the proposed algorithm is able to achieve good performance in terms of throughput and message delivery delay.

  3. LHC@home online tutorial for Mac users - recording

    CERN Document Server

    CERN. Geneva

    2016-01-01

    A step-by-step online tutorial about LHC@home for Mac users by Alexandre Racine. It contains detailed instructions on how-to-join this volunteer computing project.  There are 3 screen capture videos with the real installation process accelerated attached to the event page. This 5' video is linked from http://lhcathome.web.cern.ch/join-us Also from the CDS e-learning category.

  4. Improvisation of MAC Protocol for Wireless Sensor Network

    Directory of Open Access Journals (Sweden)

    P. Iswarya

    2013-05-01

    Full Text Available Wireless sensor networks are collection of sensor nodes connected via wireless LAN links. The information gathered at sensor node is propagates in the form of radio signal to control room via multi hop communication. In the networks, many sensors where lying in same channel to pass message, so as well as minimize the power efficient and delay for sensor networks. An Efficient Medium Access (MAC protocol is critical for the performance of a Wireless Sensor Networks (WSN, especially in terms of energy consumption. IMAC is a Time Division Multiple Access (TDMA scheme that extents the common single hop TDMA to a multi hop sensor network, using a high-powered base station to synchronize the nodes and to schedule their transmission and receptions. The protocol first enables the base station together with topology (connectivity information. A scheduling algorithm, then determines when each node should receive data and the access point announces the transmission schedule to the other nodes. The performance of EEMAC is compared to existing protocols based on simulations in NS2 (network simulator. In this paper, we discuss about the Energy Efficiency of the MAC (EEMAC and improvising the MAC protocol (IMAC, based on simulation results we show that IMAC has smaller energy and delay compared to EEMAC

  5. Anesthesia for Pediatric Patients with Prader-Willi Syndrome: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Chi-Hao Tseng

    2003-06-01

    Full Text Available Prader-Willi syndrome (PWS is a sporadic disorder of chromosome abnormalities withan estimated prevalence of 1 in 15,000. It mainly affects the central nervous system, andoften involves the hypothalamus. Both general and regional anesthesia for these patients isdifficult mainly due to morbid obesity. Other common problems include hypotonia, disturbancein thermoregulation, arrhythmia, cor pulmonale, diabetes mellitus, behavior problems,and convulsions. We report on 2 pediatric patients with PWS receiving general anesthesia.The first patient experienced life-threatening episodes of severe hypoxemia in the postanesthesiacare unit (PACU as well as in the pediatric intensive care unit (PICU. Nasal continuouspositive airway pressure (CPAP was suggested by the pediatric pulmonary medicinespecialist, and thereafter the patient's condition improved. The clinical course of the secondpatient was uneventful except for transient intermittent episodes of bronchospasms duringemergence. In addition, we discuss differences between these 2 cases and our strategy forthe prevention of perioperative complications for PWS patients in the future.

  6. Dental treatment of handicapped patients using endotracheal anesthesia.

    OpenAIRE

    Pohl, Y.; A. Filippi; GEIGER, G.; Kirschner, H; Boll, M.

    1996-01-01

    Dental treatment using endotracheal anesthesia is indicated where acute odontogenic infections, accidental injuries, or multiple caries and periodontitis marginalis require surgical and/or restorative treatment. It is also indicated where it is not possible to use psychological support during local anesthesia or during premedication or analgosedation. Dental treatment of handicapped patients using endotracheal anesthesia is described, along with indication and frequency of such treatment. The...

  7. 25 gauge vitrectomy under topical anesthesia: A pilot study

    OpenAIRE

    Raju Biju; Raju NSD; Raju Anju

    2006-01-01

    Aims: To evaluate the safety and efficacy of transconjunctival 25 gauge vitrectomy under topical anesthesia. Settings and Design: A pilot study of consecutive cases which underwent 25 gauge vitrectomy under topical anesthesia. Materials and Methods: Seven eyes of 7 patients underwent 25 gauge vitrectomy under topical anesthesia with a pledget soaked in anesthetic, for vitreous hemorrhage (2 eyes), retained cortex (1 eye) and postoperative endophthalmitis (4 eyes). Subjective pain and dis...

  8. Modeling the dynamical effects of anesthesia on brain circuits

    OpenAIRE

    Ching, ShiNung; Brown, Emery N

    2014-01-01

    General anesthesia is a neurophysiological state that consists of unconsciousness, amnesia, analgesia, and immobility along with maintenance of physiological stability. General anesthesia has been used in the United States for more than 167 years. Now, using systems neuroscience paradigms how anesthetics act in the brain and central nervous system to create the states of general anesthesia is being understood. Propofol is one of the most widely used and the most widely studied anesthetics. Wh...

  9. EL CERRO DE POTOSÍ Y EL DIOS PACHACÁMAC THE CERRO DE POTOSÍ AND THE PACHACÁMAC GOD

    OpenAIRE

    Teresa Gisbert

    2010-01-01

    En este trabajo se plantea que el Cerro de Potosí se ocultó a los españoles por ser el santuario más importante de la región, el cual estaba dedicado al dios Pachacámac. Los testimonios que indican que el cerro de Potosí era "Apu" (Cerro o Señor) adorado son abundantes, pero es el cronista Arzans de Orsúa y Vela (año 1736) quien dice que este "Apu" pertenecía a Pachacámac, dios del mundo subterráneo. Una tradición recogida cerca del salar de Uyuni dice lo mismo; finalmente un sacrificio reali...

  10. Different Aspects of General Anesthesia in Pediatric Dentistry: A Review

    Science.gov (United States)

    Ramazani, Nahid

    2016-01-01

    Context Most child population is able to undergo dental treatment in the conventional setting. However, some children fail to cope with in-office conscious state and cannot respond to usual management modalities. This review aims to discuss the topic further. Evidence Acquisition A computerized search in databases PubMed, MEDLINE, EMBASE, Google Scholar and Google were performed using dental general anesthesia related keywords. Original and review English-written articles that were limited to child population were retrieved without any limitation of publication date. The suitable papers were selected and carefully studied. A data form designed by author was used to write relevant findings. Results Preoperative oral examination and comprehensive evaluation of treatment needs is only possible after clinical and radiographic oral examination. Effective collaboration in dental GA team should be made to minimize psychological trauma of children who undergo dental GA. Before conducting comprehensive dental treatment under GA, the general health of the child and the success rate of procedures provided needs to be accurately evaluated. It is noteworthy that determination of the optimal timing for GA dental operation is of great importance. Providing safety with pediatric dental rehabilitation under GA is critical. Conclusions Besides criteria for case selection of dental GA, some degree of dental practitioner’s judgment is required to make decision. Pre- and post-operative instructions to parents or caregiver decrease the risk of complications. However, trained resuscitation providers, careful monitoring and advanced equipment minimize adverse outcomes. PMID:27307962

  11. The application of sacral block anesthesia in pediatric interventional therapy

    International Nuclear Information System (INIS)

    Objective: To discuss the management and feasibility of sacral block anesthesia in pediatric interventional therapy. Methods: A total of 80 pediatric patients were randomly and equally divided into two groups. Patients in group A received sacral block anesthesia together with basic anesthesia with propofol, while patients in group B received intravenous anesthesia with propofol. Small amount of ketamine as maintaining dose was used in both groups when needed. Results: The interventional management was successfully completed in all patients. A marked decrease in blood pressure occurred in three patients of group A receiving sacral block anesthesia. In group B receiving intravenous anesthesia, a decrease of SpO2 to below 90 percent was seen in 8 cases, and obvious bradycardia developed in 12 cases. All these patients were treated with intravenous medication or by reducing the dose of propofol. Additional small dose of ketamine was needed in 4 patients during the procedure. Conclusion: Sacral block anesthesia combined with intravenous anesthesia is one of the effective anesthesia management schemes for pediatric interventional therapy. (authors)

  12. Caudal epidural anesthesia during intracavitary brachytherapy for cervical cancer

    International Nuclear Information System (INIS)

    It has been suggested that pain control during intracavitary brachytherapy for cervical cancer is insufficient in most hospitals in Japan. Our hospital began using caudal epidural anesthesia during high-dose-rate (HDR) intracavitary brachytherapy in 2011. The purpose of the present study was to retrospectively investigate the effects of caudal epidural anesthesia during HDR intracavitary brachytherapy for cervical cancer patients. Caudal epidural anesthesia for 34 cervical cancer patients was performed during HDR intracavitary brachytherapy between October 2011 and August 2013. We used the patients' self-reported Numeric Rating Scale (NRS) score at the first session of HDR intracavitary brachytherapy as a subjective evaluation of pain. We compared NRS scores of the patients with anesthesia with those of 30 patients who underwent HDR intracavitary brachytherapy without sacral epidural anesthesia at our hospital between May 2010 and August 2011. Caudal epidural anesthesia succeeded in 33 patients (97%), and the NRS score was recorded in 30 patients. The mean NRS score of the anesthesia group was 5.17 ± 2.97, significantly lower than that of the control group's 6.80 ± 2.59 (P = 0.035). The caudal epidural block resulted in no side-effects. Caudal epidural anesthesia is an effective and safe anesthesia option during HDR intracavitary brachytherapy for cervical cancer. (author)

  13. Down-Regulated MAC30 Expression Inhibits Proliferation and Mobility of Human Gastric Cancer Cells

    Directory of Open Access Journals (Sweden)

    Xiao-Yan Xu

    2014-05-01

    Full Text Available Background: Gastric cancer is one of the most common cancers in the world. MAC30/Transmembrane protein 97 (TMEM97 is aberrantly up-regulated in many human carcinoma cells. However, the function of MAC30 in gastric carcinoma cells is not studied. Material and Methods: To investigate the function of MAC30 in gastric carcinoma, we used RNA silencing technology to knock down the expression of MAC30 in gastric cancer cells BGC-823 and AGS. Real-time quantitative PCR and Western blot were used to analyze the mRNA level and the related protein expression. The localization of MAC30 and lamellipodia was observed by immunofluorescence. The biological phenotypes of gastric cells were examined by cell proliferation assay, cell cycle analysis, apoptosis assay, cell migration and invasion assay. Results: We found that down-regulation of MAC30 expression efficiently inhibited the proliferation of gastric cancer cells. Furthermore, the mobility of gastric cancer cells was also inhibited by down-regulation of MAC30. Moreover, we found that MAC30 knockdown inhibited AKT phosphorylation and reduced the expression of cyclinB1 and WAVE2. Conclusion: To our knowledge, this is the first report investigating the effect of MAC30 on growth, cell cycle, migration, and invasion in gastric carcinoma cells via suppressing AKT signaling pathway. MAC30 may be a potential therapeutic target for treatment of gastric carcinoma.

  14. Development of the CoMac Adherence Descriptor™: a linguistically-based survey for segmenting patients on their worldviews

    OpenAIRE

    Connor UM; Mac Neill Jr RS; Mzumara HR; Sandy R

    2015-01-01

    Ulla M Connor,1 Robert S Mac Neill Jr,1 Howard R Mzumara,2 Robert Sandy1 1International Center for Intercultural Communication (ICIC), Indiana University – Purdue University, Indianapolis, IN, USA; 2Testing Center – Division of Planning and Institutional Improvement, Indiana University – Purdue University, Indianapolis, IN, USA Abstract: Nonadherence to prescribed medication and healthy behaviors is a pressing health care issue. Much research has been conducted in this are...

  15. Development of the CoMac Adherence Descriptor™: a linguistically-based survey for segmenting patients on their worldviews

    OpenAIRE

    Connor, Ulla

    2015-01-01

    Ulla M Connor,1 Robert S Mac Neill Jr,1 Howard R Mzumara,2 Robert Sandy1 1International Center for Intercultural Communication (ICIC), Indiana University – Purdue University, Indianapolis, IN, USA; 2Testing Center – Division of Planning and Institutional Improvement, Indiana University – Purdue University, Indianapolis, IN, USA Abstract: Nonadherence to prescribed medication and healthy behaviors is a pressing health care issue. Much research has been conducted...

  16. Effects of Isoflurane Anesthesia on Post-Anesthetic Sleep-Wake Architectures in Rats

    OpenAIRE

    Jang, Hwan-Soo; Jung, Ji-Young; Jang, Kwang-Ho; Lee, Maan-Gee

    2010-01-01

    The sleep homeostatic response significantly affects the state of anesthesia. In addition, sleep recovery may occur during anesthesia, either via a natural sleep-like process to occur or via a direct restorative effect. Little is known about the effects of isoflurane anesthesia on sleep homeostasis. We investigated whether 1) isoflurane anesthesia could provide a sleep-like process, and 2) the depth of anesthesia could differently affect the post-anesthesia sleep response. Nine rats were trea...

  17. Comparison of Total Intravenous Anesthesia (TIVA with Inhalation Anesthesia in Pediatric Bronchoscopy

    Directory of Open Access Journals (Sweden)

    Majid Razavi

    2013-12-01

    Full Text Available Background: Because of airway stimulations during the bronchoscopy and lack of direct access to the airway, preferred method of anesthesia for rigid bronchoscopy is already controversial. In this study we compared inhalation anesthesia with total intravenous anesthesia (TIVA for rigid bronchoscopy. Method and Materials: 30 patients aged 2-6 years were chosen divided on two same groups. Anesthesia in group I maintained with halothane and in group II maintained with remifentanil and propofol. Oxygenation, heart rate, respiratory rate, coughing, bucking, laryngospasm, bronchospasm were evaluated during and after surgery. Also Operation success and surgeon’s satisfaction were recorded as well.Results: Demographic findings were the same in both groups. Oxygenation and heart rate were more stable in group II (P=0.047 and P=0.026 respectively but there was no significant difference in respiratory rate between two groups (P=1. Success rate was also similar in both groups but surgeon’s satisfaction was significantly higher in TIVA (P=0.003. There was not any significant different between complications in two groups. Conclusion: We suggest TIVA for rigid bronchoscopy because of better oxygenation, more homodynamic stability, surgeon’s satisfaction, lack of air pollution and less interference with surgeon’s visual field.

  18. Anesthesia for tracheostomy for huge maxillofacial tumor

    Directory of Open Access Journals (Sweden)

    Abeer A Arab

    2014-01-01

    Full Text Available Providing sedation for patients with compromised upper airway is challenging. A 19-year-old female patient with huge maxillofacial tumor invading the whole pharynx scheduled for elective tracheostomy under local anesthesia due to compromised airway. The patient had gastrostomy tube for feeding. Venous cannulation was totally refused by the patient after repeated trials for exhausted sclerosed veins. Pre-operative mixture of dexmedetomidine with ketamine was administered through the gastrostomy tube with eutectic mixture of local anesthetics cream application over the planned tracheostomy site. The patient was sedated with eye opening to command. Local infiltration followed by tracheostomy was performed without patient complaints or recall of operative events.

  19. Anesthesia condition for {sup 18}F-FDG imaging of lung metastasis tumors using small animal PET

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Sang-Keun; Lee, Tae Sup; Kim, Kyeong Min; Kim, June-Youp; Jung, Jae Ho; Kang, Joo Hyun [Division of Nuclear Medicine and RI Application, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of); Cheon, Gi Jeong [Division of Nuclear Medicine and RI Application, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of); Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of)], E-mail: larry@kcch.re.kr; Choi, Chang Woon; Lim, Sang Moo [Division of Nuclear Medicine and RI Application, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of); Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of)

    2008-01-15

    Small animal positron emission tomography (PET) with {sup 18}F-FDG has been increasingly used for tumor imaging in the murine model. The aim of this study was to establish the anesthesia condition for imaging of lung metastasis tumor using small animal {sup 18}F-FDG PET. Methods: To determine the impact of anesthesia on {sup 18}F-FDG distribution in normal mice, five groups were studied under the following conditions: no anesthesia, ketamine and xylazine (Ke/Xy), 0.5% isoflurane (Iso 0.5), 1% isoflurane (Iso 1) and 2% isoflurane (Iso 2). The ex vivo counting, standard uptake value (SUV) image and glucose SUV of {sup 18}F-FDG in various tissues were evaluated. The {sup 18}F-FDG images in the lung metastasis tumor model were obtained under no anesthesia, Ke/Xy and Iso 0.5, and registered with CT image to clarify the tumor region. Results: Blood glucose concentration and muscle uptake of {sup 18}F-FDG in the Ke/Xy group markedly increased more than in the other groups. The Iso 2 group increased {sup 18}F-FDG uptake in heart compared with the other groups. The Iso 0.5 anesthesized group showed the lowest {sup 18}F-FDG uptake in heart and chest wall. The small size of lung metastasis tumor (2 mm) was clearly visualized by {sup 18}F-FDG image with the Iso 0.5 anesthesia. Conclusion: Small animal {sup 18}F-FDG PET imaging with Iso 0.5 anesthesia was appropriate for the detection of lung metastasis tumor. To acquire {sup 18}F-FDG PET images with small animal PET, the type and level of anesthetic should be carefully considered to be suitable for the visualization of target tissue in the experimental model.

  20. Cardiac arrest upon induction of anesthesia in children with cardiomyopathy: an analysis of incidence and risk factors.

    LENUS (Irish Health Repository)

    Lynch, Johanne

    2012-02-01

    INTRODUCTION: It is thought that patients with cardiomyopathy have an increased risk of cardiac arrest on induction of anesthesia, but there is little available data. The purpose of this study was to identify the incidence and potential risk factors for cardiac arrest upon induction of anesthesia in children with cardiomyopathy in our institution. METHODS: A retrospective chart review was performed. Eligible patients included patients admitted between 1998 and 2008 with the International Statistical Classification of Disease code for cardiomyopathy (ICD-9 code 425) who underwent airway intervention for sedation or general anesthesia in the operating room, cardiac diagnostic and interventional unit (CDIU) or intensive care unit. Patients undergoing emergency airway intervention following cardiovascular collapse were excluded. For each patient, we recorded patient demographics, disease severity, anesthesia location, and anesthetic technique. RESULTS: One hundred and twenty-nine patients with cardiomyopathy underwent a total of 236 anesthetic events, and four cardiac arrests were identified. One was related to bradycardia (HR<60), two were attributed to bradycardia in association with severe hypotension (systolic blood pressure<45), and the fourth arrest was related to isolated severe hypotension. Two occurred in the operating suite and two in the CDIU. There was no resulting mortality. One patient progressed to heart transplantation. Multiple combinations of anesthetic drugs were used for induction of anesthesia. CONCLUSION: We performed a review of the last 10 years of anesthesia events in children with cardiomyopathy. We report four cardiac arrests in two patients and 236 anesthetic events (1.7%). To the best of our knowledge, this is the largest review of these patients to date but is limited by its retrospective nature. The low cardiac arrest incidence prevents the identification of risk factors and the development of a cardiac arrest risk predictive clinical

  1. Hemodynamic stability, myocardial ischemia, and perioperative outcome after carotid surgery with remifentanil/propofol or isoflurane/fentanyl anesthesia.

    Science.gov (United States)

    Jellish, W Scott; Sheikh, Taqdees; Baker, William H; Louie, Eric K; Slogoff, Stephen

    2003-07-01

    This study compares remifentanil/propofol (remi/prop) with isoflurane/fentanyl (iso/fen) anesthesia to determine which provides the greater hemodynamic stability, lesser myocardial ischemia, and morbidity with better postoperative outcomes after carotid endarterectomy. Sixty patients undergoing unilateral carotid endarterectomy were randomized to receive either a remi/prop or iso/fen anesthetic. Hemodynamic variables were recorded during the surgical procedure. In addition, transesophageal echocardiography was used to assess evidence of intraoperative regional wall motion abnormalities suggestive of cardiac ischemia. Emergence and extubation times, recovery from anesthesia, hemodynamic instability, nausea, vomiting, and pain in post anesthesia recovery, discharge delays, ICU admittance, hospital discharge, and preoperative and postoperative troponin levels were compared using appropriate statistical methods with P < 0.05 considered significant. The groups were demographically alike. Hemodynamic variables were similar during intubation and throughout surgery. Twenty-two percent of patients receiving iso/fen developed intraoperative regional wall motion abnormalities suggestive of ischemia, whereas no remi/prop patients had changes (P < 0.05). There was no difference in ST-T wave changes after surgery, and no patient had an elevation in troponin I levels. Postoperative variables were similar except that patients who received iso/fen had lower Stewart recovery scores during the first 15 minutes after post anesthesia care unit admission and a higher incidence of nausea and vomiting the day after surgery, whereas patients receiving remi/prop had discharge delays secondary to hypertension. ICU admittance, time to first void, oral intake, and time to hospital discharge were similar between the groups. At 9 times the cost of an iso/fen anesthesia technique, remi/prop offers little advantage over inhalational anesthesia for carotid endarterectomy. PMID:12826964

  2. SURVEILLANCE OF BACTERIAL CONTAMINATION OF ANESTHESIA MACHINE AND PERIPHERAL INTRAVENOUS CANNULA DURING GENERAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Ch. Srinivas

    2015-01-01

    Full Text Available BACKGROUND: Given the expanding role of the anesthesiologist as the “total perioperative physician,” the increasing number of invasive procedures performed by anesthesiologists, and the increase in the prevalence of emerging diseases, stringent attention to infection control practices is paramount. AIM : To find out the bacterial contamination of anesthesia machine and internal lumen of the injection port of peri pheral intravenous cannula, and evaluation of its risk factors during general anesthesia procedures. MATERIALS AND METHODS: 50 general anaesthesia procedures were selected randomly after the approval of ethics committee and informed consent from the patien t. Samples were taken for bacterial culture on 2 sites in anesthesia machine (Adjustable pressure limiting valve {APL} and agent concentration dial of inhaled anesthetics{AD} and internal lumen of the injection port of peripheral intravenous cannula befor e starting and after completion of procedures. Bacteria and colony count were identified according to standard laboratory methods . RESULTS : Adjustable pressure limiting valve area was contaminated with bacteria in 12% (6/50 before starting procedure and 34% (17/50 after completion of procedures. Agent concentration dial of inhaled anesthetic site was contaminated with bacteria in 10% (5/50 before starting procedure and 28% (14/50 after completion of procedures. Bacterial contamination occurred in the i nternal lumen of the injection port of peripheral intravenous cannula in 16% (8/50 during general anesthesia. Isolated bacteria in anesthesia machine and peripheral intra venous cannula sites are STAPHYLO COCCI, STREPTOCOCCI, MICRO COCCI, ENTERO COCCI, E. COLI, and PSEUDOMONAS . CONCLUSION: Bacterial contamination is significantly associated with procedure order in a day (bacterial contamination rate is increased from first procedure to fifth procedure in a day. It is significantly associated with surgical s pecialty highest in

  3. TMAC: Timestamp-Ordered MAC Protocol for Wireless Mesh Networks

    KAUST Repository

    Nawab, Faisal

    2011-05-01

    Wireless Mesh Networks (WMNs) have emerged to meet a need for a self-organized and self-configured multi-hop wireless network infrastructure. Low cost infrastructure and ease of deployment have made WMNs an attractive technology for last mile access. However, 802.11 based WMNs are subject to serious fairness issues. With backlogged TCP traffic, nodes which are two or more hops away from the gateway are subject to starvation, while the one-hop away node saturates the channel with its own local traffic. We study the interactions of TCP and IEEE 802.11 MAC in WMNs to aid us in understanding and overcoming the unfairness problem. We propose a Markov chain to capture the behavior of TCP sessions, particularly the impact on network throughput performance due to the effect of queue utilization and packet relaying. A closed form solution is derived to numerically derive the throughput. Based on the developed model, we propose a distributed MAC protocol called Timestamp-ordered MAC (TMAC), aiming to alleviate the unfairness problem in WMNs via a manipulative per-node scheduling mechanism which takes advantage of the age of each packet as a priority metric. Simulation is conducted to validate our model and to illustrate the fairness characteristics of TMAC. Our results show that TMAC achieves excellent resource allocation fairness while maintaining above 90% of maximum link capacity in parking lot and large grid topologies. Our work illuminates the factors affecting TCP fairness in WMNs. Our theoretical and empirical findings can be used in future research to develop more fairness-aware protocols for WMNs.

  4. Simulation of electroencephalographic signals for depth of anesthesia assessment

    Science.gov (United States)

    Panichev, Oleg; Popov, Anton; Bodilovskyi, Oleg; Tkachenko, Valerii

    2011-10-01

    The problem of simulating electroencephalographic (EEG) signals for different stages of anesthesia is considered. Review of existing techniques for EEG simulation is made and the new technique for simulating the EEG using only preliminary definition of magnitudes of harmonic components for every frequency ranges is presented. During experimental part EEG signals for four stages of ether anesthesia were simulated.

  5. Awareness during general anesthesia: new technology for an old problem.

    Science.gov (United States)

    Halliburton, J R

    1998-05-01

    The possibility of awareness during general anesthesia causes apprehension for the patient and the Certified Registered Nurse Anesthetist (CRNA). The goals of general anesthesia are to prevent the sensation of pain and produce a state of sedation, hypnosis, and unconsciousness so the patient will not remember the surgical procedure. An inadequate level of anesthesia can result in patient awareness during surgery. The current practice of anesthesia relies on indirect hemodynamic measurements such as blood pressure and heart rate to monitor the sedative hypnotic state of the patient's brain during general anesthesia. Hemodynamic responses are not reliable for predicting awareness just as blood pressure and heart rate are not indicative of consciousness. Electroencephalogram (EEG) waveforms are known to be affected by anesthetics. Characteristic EEG waveforms are a direct indication of the patient's level of consciousness. Unprocessed and computer-processed EEG recordings have been used in an attempt to monitor the patient's level of consciousness during general anesthesia. A raw or unprocessed EEG recording to monitor the level of consciousness during general anesthesia is problematic. The EEG signal is complex, affected by artifact, and it requires a dedicated interpreter. Conventional processed EEG monitoring systems are problematic because of the complexity of the equipment and technical difficulty of reading the EEG recording. The purpose of this article is to describe the history of awareness during anesthesia and introduce a new processed EEG monitor, the Bispectral Index (BIS) (Aspect Medical Systems, Inc., Natick, MA) with implications for future clinical use and research. PMID:9726194

  6. General anesthesia suppresses normal heart rate variability in humans

    Science.gov (United States)

    Matchett, Gerald; Wood, Philip

    2014-06-01

    The human heart normally exhibits robust beat-to-beat heart rate variability (HRV). The loss of this variability is associated with pathology, including disease states such as congestive heart failure (CHF). The effect of general anesthesia on intrinsic HRV is unknown. In this prospective, observational study we enrolled 100 human subjects having elective major surgical procedures under general anesthesia. We recorded continuous heart rate data via continuous electrocardiogram before, during, and after anesthesia, and we assessed HRV of the R-R intervals. We assessed HRV using several common metrics including Detrended Fluctuation Analysis (DFA), Multifractal Analysis, and Multiscale Entropy Analysis. Each of these analyses was done in each of the four clinical phases for each study subject over the course of 24 h: Before anesthesia, during anesthesia, early recovery, and late recovery. On average, we observed a loss of variability on the aforementioned metrics that appeared to correspond to the state of general anesthesia. Following the conclusion of anesthesia, most study subjects appeared to regain their normal HRV, although this did not occur immediately. The resumption of normal HRV was especially delayed on DFA. Qualitatively, the reduction in HRV under anesthesia appears similar to the reduction in HRV observed in CHF. These observations will need to be validated in future studies, and the broader clinical implications of these observations, if any, are unknown.

  7. The Effect of Neuraxial Anesthesia on Maternal Cerebral Hemodynamics

    NARCIS (Netherlands)

    Postma, Ineke R.; van Veen, Teelkien R.; Mears, Scott L.; Zeeman, Gerda G.; Haeri, Sina; Belfort, Michael A.

    2014-01-01

    Objective Neuraxial anesthesia is known to reduce sympathetic tone and mean arterial pressure. Effects on cerebral hemodynamics in pregnancy are not well known. We hypothesize that cerebral hemodynamic parameters will change with respect to baseline following regional analgesia/anesthesia. Study Des

  8. Disruption of the MacMARCKS gene prevents cranial neural tube closure and results in anencephaly.

    OpenAIRE

    Chen, J; Chang, S.; Duncan, S A; Okano, H J; Fishell, G.; Aderem, A

    1996-01-01

    MacMARCKS is a member of the MARCKS family of protein kinase C (PKC) substrates. Biochemical evidence demonstrates that these proteins integrate calcium and PKC-dependent signals to regulate actin structure at the membrane. We report here that deletion of the MacMARCKS gene prevents cranial neural tube closure in the developing brain, resulting in anencephaly. This suggests a central role for MacMARCKS and the PKC signal transduction pathway in the folding of the anterior neural plate during ...

  9. Independent Metalloregulation of Ace1 and Mac1 in Saccharomyces cerevisiae

    OpenAIRE

    Keller, Greg; Bird, Amanda; Winge, Dennis R.

    2005-01-01

    Ace1 and Mac1 undergo reciprocal copper metalloregulation in yeast cells. Mac1 is functional as a transcriptional activator in copper-deficient cells, whereas Ace1 is a transcriptional activator in copper-replete cells. Cells undergoing a transition from copper-deficient to copper-sufficient conditions through a switch in the growth medium show a rapid inactivation of Mac1 and a corresponding rise in Ace1 activation. Cells analyzed after the transition show a massive accumulation of cellular ...

  10. Expression analysis of MAC30 in human pancreatic cancer and tumors of the gastrointestinal tract

    OpenAIRE

    Kayed, Hany; Kleeff, Jörg; Ding, J.; Hammer, J.; Giese, T; Zentgraf, H; Büchler, M W; Friess, Helmut

    2004-01-01

    Meningioma-associated protein, MAC30, is a protein with unknown function and cellular localization that is differentially expressed in certain malignancies. In the present study, the expression of MAC30 in a variety of normal and cancerous human gastrointestinal tissues, with special emphasis on pancreatic tissues was analyzed. Quantitative RT-PCR was utilized to compare MAC30 expression levels. In situ hybridization and immunohistochemistry were carried ou...

  11. Subcellular localization and dynamics of Mac-1 (alpha m beta 2) in human neutrophils.

    OpenAIRE

    Sengeløv, H.; Kjeldsen, L; Diamond, M S; Springer, T A; Borregaard, N

    1993-01-01

    The subcellular localization of Mac-1 was determined in resting and stimulated human neutrophils after disruption by nitrogen cavitation and fractionation on two-layer Percoll density gradients. Light membranes were further separated by high voltage free flow electrophoresis. Mac-1 was determined by an ELISA with monoclonal antibodies that were specific for the alpha-chain (CD11b). In unstimulated neutrophils, 75% of Mac-1 colocalized with specific granules including gelatinase granules, 20% ...

  12. Cooperative Communications inWireless Local Area Networks: MAC Protocol Design and Multi-layer Solutions

    OpenAIRE

    He, Xin

    2012-01-01

    This dissertation addresses cooperative communications and proposes multi-layer solu- tions for wireless local area networks, focusing on cooperative MAC design. The coop- erative MAC design starts from CSMA/CA based wireless networks. Three key issues of cooperation from the MAC layer are dealt with: i.e., when to cooperate (opportunistic cooperation), whom to cooperate with (relay selection), and how to protect cooperative transmissions (message procedure design). In addition...

  13. Opportunistic scheduling for WLAN systems using cross-layer techniques and a distributed MAC

    OpenAIRE

    Cateura, A; Alonso Zárate, Luis Gonzaga; Verikoukis, Christos

    2005-01-01

    This paper proposes a novel Cross-Layer optimization mechanism for WLAN systems and analyses its performance in terms of throughput and mean packet delay. The proposed scheme makes use of a MAC-PHY interaction and a nearoptimum distributed MAC to improve radio channel utilisation. The proposed technique allows the MAC layer to improve the system efficiency by means of certain PHY information knowledge. Simulation results show that the obtained benefits are quite remark...

  14. Detection of Masqueraded Wireless Access Using 802.11 MAC Layer Fingerprints

    OpenAIRE

    Idland, Christer; Jelle, Thomas; Mjølsnes, Stig Frode

    2013-01-01

    Many wireless Internet access operators prefer open local area network (WLAN) access because this reduces the need for user assistance for a variety of smaller devices. A 802.11 MAC spoofer masquerades as an authorized user and gains access by using an already whitelisted MAC address. We consider the scenario where the spoofer waits until the authorized user has finished the session, and then uses the still whitelisted MAC address for the network access. We propose and experiment with “implem...

  15. Performance evaluation of IEEE 802.11 MAC layer in supporting delay sensitive services

    OpenAIRE

    Jyotsna Sengupta; Gurpreet Singh Grewal

    2010-01-01

    Providing QoS requirements like good throughput and minimum access delay are challenging tasks with regard to 802.11 WLAN protocols and Medium Access Control (MAC) functions. IEEE 802.11 MAC layer supports two main protocols: DCF (Distributed Coordination Function) and EDCF (Enhanced Distributed Coordination Function). During the evaluation of EDCF, the performance of various access categories was thedetermining factor. Two scenarios, with same Physical and MAC parameters, one implementing th...

  16. Tournament MAC with Constant Size Congestion Window for WLAN

    CERN Document Server

    Galtier, Jerome

    2007-01-01

    In the context of radio distributed networks, we present a generalized approach for the Medium Access Control (MAC) with fixed congestion window. Our protocol is quite simple to analyze and can be used in a lot of different situations. We give mathematical evidence showing that our performance is tight, in the sense that no protocol with fixed congestion window can do better. We also place ourselves in the WiFi/WiMAX framework, and show experimental results enlightening collision reduction of 14% to 21% compared to the best known other methods. We show channel capacity improvement, and fairness considerations.

  17. Mac configuration management at the Los Alamos National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Marcus, Allan B [Los Alamos National Laboratory

    2010-01-01

    The Los Alamos National Laboratory (LANL) had a need for central configuration management of non-Windows computers. LANL has three to five thousand Macs and an equal number of Linux based systems. The primary goal was to be able to inventory all non-windows systems and patch Mc OS X systems. LANL examined a number of commercial and open source solutions and ultimately selected Puppet. This paper will discuss why we chose Puppet, how we implemented it, and some lessons we learned along the way.

  18. NUEVOS PERFILES LABORALES. EL CASO DE TECÁMAC

    OpenAIRE

    Edgar Torres Escalona; Miguel Ángel Morales Sánchez; Víctor Manuel García Pliego

    2010-01-01

    El presente estudio tiene por objetivo describir la evolución y situación de las PYME ante el impacto de la economía mundial, después del neoliberalismo y más específicamente las PYMES del área de Tecámac estado de México, el trabajo busca establecen la situación del sector comercial industria y de servicios, con respecto al personal laboral que demanda, a partir de sus necesidades de actividades más complejas que la cultura laboral tradicional no tienen. El trabajo en su aspecto metodológico...

  19. A Performance Comparison of Two Real Time WLAN MAC Protocols

    Institute of Scientific and Technical Information of China (English)

    CAO Chun-sheng; LI Feng; ZHANG Wei-dong

    2007-01-01

    By modifying the IEEE 802.11 wireless local area network (WLAN) medium access protocol (MAC), a contention based and a polling based protocol are proposed to deal with the case every station possesses two classes of frame in real time applications. Both protocols can ensure the real time frame only need to wait a determinable bounded time. These two protocols are introduced briefly and a performance comparison between them is made. Simulation results show that each protocol has advantage over the others in certain network condition.

  20. Recruitment maneuvers in acute respiratory distress syndrome and during general anesthesia.

    Science.gov (United States)

    Chiumello, Davide; Algieri, Ilaria; Grasso, Salvatore; Terragni, Pierpaolo; Pelosi, Paolo

    2016-02-01

    The use of low tidal volume ventilation and low to moderate positive end-expiratory pressure (PEEP) levels is a widespread strategy to ventilate patients with non-injured lungs during general anesthesia and in intensive care as well with mild to moderate acute respiratory distress syndrome (ARDS). Higher PEEP levels have been recommended in severe ARDS. Due to the presence of alveolar collapse, recruitment maneuvers (RMs) by causing a transient elevation in airway pressure (i.e. transpulmonary pressure) have been suggested to improve lung inflation in non-inflated and poorly-inflated lung regions. Various types of RMs such as sustained inflation at high pressure, intermittent sighs and stepwise increases of PEEP and/or airway plateau inspiratory pressure have been proposed. The use of RMs has been associated with mixed results in terms of physiological and clinical outcomes. The optimal method for RMs has not yet been identified. The use of RMs is not standardized and left to the individual physician based on his/her experience. Based on the same grounds, RMs have been proposed to improve lung aeration during general anesthesia. The aim of this review was to present the clinical evidence supporting the use of RMs in patients with ARDS and during general anesthesia and as well their potential biological effects in experimental models of acute lung injury. PMID:25881732

  1. Fast track anesthesia for liver transplantation: Review of the current practice.

    Science.gov (United States)

    Aniskevich, Stephen; Pai, Sher-Lu

    2015-09-18

    Historically, patients undergoing liver transplantation were left intubated and extubated in the intensive care unit (ICU) after a period of recovery. Proponents of this practice argued that these patients were critically ill and need time to be properly optimized from a physiological and pain standpoint prior to extubation. Recently, there has been a growing movement toward early extubation in transplant centers worldwide. Initially fueled by research into early extubation following cardiac surgery, extubation in the operating room or soon after arrival to the ICU, has been shown to be safe with proper patient selection. Additionally, as experience at determining appropriate candidates has improved, some institutions have developed systems to allow select patients to bypass the ICU entirely and be admitted to the surgical ward after transplant. We discuss the history of early extubation and the arguments in favor and against fast track anesthesia. We also described our practice of fast track anesthesia at Mayo Clinic Florida, in which, we extubate approximately 60% of our patients in the operating room and send them to the surgical ward after a period of time in the post anesthesia recovery unit. PMID:26380654

  2. Improving Patient Safety in Anesthesia: A Success Story?

    International Nuclear Information System (INIS)

    Anesthesia is necessary for surgery; however, it does not deliver any direct therapeutic benefit. The risks of anesthesia must therefore be as low as possible. Anesthesiology has been identified as a leader in improving patient safety. Anesthetic mortality has decreased, and in healthy patients can be as low as 1:250,000. Trends in anesthetic morbidity have not been as well defined, but it appears that the risk of injury is decreasing. Studies of error during anesthesia and Closed Claims studies have identified sources of risk and methods to reduce the risks associated with anesthesia. These include changes in technology, such as anesthetic delivery systems and monitors, the application of human factors, the use of simulation, and the establishment of reporting systems. A review of the important events in the past 50 years illustrates the many steps that have contributed to the improvements in anesthesia safety

  3. A rare complication of spinal anesthesia: Intracranial subdural hemorrhage

    Directory of Open Access Journals (Sweden)

    Cengiz Kaplan

    2015-02-01

    Full Text Available Spinal (subarachnoid anesthesia (SA is a widely used general-purpose anesthesia. Postdural Puncture Headaches (PDPHs represent one of the principal complications of spinal anesthesia. A 21-year-old man underwent inguinal herniorrhaphy and orchiectomy using spinal anesthesia. Postoperatively, our patient started to have a headache with nausea. The patient received symptomatic therapy, but the severe headache persisted even in the supine position, with his vital signs and neurological examination being normal. Cranial MRI showed a bilateral subdural hematoma from his frontal to temporal region. A postdural puncture headache is a frequent complication after spinal anesthesia. However, serious complications, such as an intracranial subdural hemorrhage, can rarely occur. [Arch Clin Exp Surg 2015; 4(1.000: 54-56

  4. Power-Controlled MAC Protocols with Dynamic Neighbor Prediction for Ad hoc Networks

    Institute of Scientific and Technical Information of China (English)

    LI Meng; ZHANG Lin; XIAO Yong-kang; SHAN Xiu-ming

    2004-01-01

    Energy and bandwidth are the scarce resources in ad hoc networks because most of the mobile nodes are battery-supplied and share the exclusive wireless medium. Integrating the power control into MAC protocol is a promising technique to fully exploit these precious resources of ad hoc wireless networks. In this paper, a new intelligent power-controlled Medium Access Control (MAC) (iMAC) protocol with dynamic neighbor prediction is proposed. Through the elaborate design of the distributed transmit-receive strategy of mobile nodes, iMAC greatly outperforms the prevailing IEEE 802.11 MAC protocols in not only energy conservation but also network throughput. Using the Dynamic Neighbor Prediction (DNP), iMAC performs well in mobile scenes. To the best of our knowledge, iMAC is the first protocol that considers the performance deterioration of power-controlled MAC protocols in mobile scenes and then proposes a solution. Simulation results indicate that DNP is important and necessary for power-controlled MAC protocols in mobile ad hoc networks.

  5. General anesthesia for nuclear magnetic resonance imaging

    International Nuclear Information System (INIS)

    The core of the MAGNETOM diagnostic device is a liquid helium-cooled cryogenic magnet, having the shape of a hollow cylinder about 2 m long, 50 to 60 cm i.d. Its inner space is designed to accommodate a bench with the patient, whose part examined, usually the head, is enclosed in a smaller coil and is located roughly in the center of the magnet. The examination takes 4 to 20 minutes, during which the patient must be fixed to prevent any motion. Inhalation anesthesia with spontaneous ventilation using the Jackson-Rees or Bain's system and a laryngeal mask is considered the safest way where no special equipment is employed. If artificial ventilation is necessary, balanced anesthesia with either manual ventilation using Bain's system or a fluidic type ventilator seems to be the best choice. The preparation of the patient prior to the examination, the premedication, and the monitoring equipment are described. (J.B.). 1 tab., 5 figs., 11 refs

  6. The history of the nurse anesthesia profession.

    Science.gov (United States)

    Ray, William T; Desai, Sukumar P

    2016-05-01

    Despite the fact that anesthesia was discovered in the United States, we believe that both physicians and nurses are largely unaware of many aspects of the development of the nurse anesthetist profession. A shortage of suitable anesthetists and the reluctance of physicians to provide anesthetics in the second half of the 19th century encouraged nurses to take on this role. We trace the origins of the nurse anesthetist profession and provide biographical information about its pioneers, including Catherine Lawrence, Sister Mary Bernard Sheridan, Alice Magaw, Agatha Cobourg Hodgins, and Helen Lamb. We comment on the role of the nuns and the effect of the support and encouragement of senior surgeons on the development of the specialty. We note the major effect of World Wars I and II on the training and recruitment of nurse anesthetists. We provide information on difficulties faced by nurse anesthetists and how these were overcome. Next, we examine how members of the profession organized, developed training programs, and formalized credentialing and licensing procedures. We conclude by examining the current state of nurse anesthesia practice in the United States. PMID:27041264

  7. Anesthesia for subglottic stenosis in pediatrics

    Directory of Open Access Journals (Sweden)

    Eid Essam

    2009-01-01

    Full Text Available Any site in the upper airway can get obstructed and cause noisy breathing as well as dyspnea. These include nasal causes such as choanal atresia or nasal stenosis; pharyngeal causes including lingual thyroid; laryngeal causes such as laryngomalacia; tracheobronchial causes such as tracheal stenosis; and subglottic stenosis. Lesions in the oropharynx may cause stertor, while lesions in the laryngotracheal tree will cause stridor. Subglottic stenosis is the third leading cause of congenital stridors in the neonate. Subglottic Stenosis presents challenges to the anesthesiologist. Therefore, It is imperative to perform a detailed history, physical examination, and characterization of the extent and severity of stenosis. Rigid endoscopy is essential for the preoperative planning of any of the surgical procedures that can be used for correction. Choice of operation is dependent on the surgeon′s comfort, postoperative capabilities, and severity of disease. For high-grade stenosis, single-stage laryngotracheal resection or cricotracheal resection are the best options. It has to be borne in mind that the goal of surgery is to allow for an adequate airway for normal activity without the need for tracheostomy. Anesthesia for airway surgery could be conducted safely with either sevofl uraneor propofol-based total intravenous anesthesia.

  8. Respiratory diagnostic possibilities during closed circuit anesthesia.

    Science.gov (United States)

    Verkaaik, A P; Erdmann, W

    1990-01-01

    An automatic feed back controlled totally closed circuit system (Physioflex) has been developed for quantitative practice of inhalation anesthesia and ventilation. In the circuit system the gas is moved unidirectionally around by a blower at 70 l/min. In the system four membrane chambers are integrated for ventilation. Besides end-expiratory feed back control of inhalation anesthetics, and inspiratory closed loop control of oxygen, the system offers on-line registration of flow, volume and respiratory pressures as well as a capnogram and oxygen consumption. Alveolar ventilation and static compliance can easily be derived. On-line registration of oxygen consumption has proven to be of value for determination of any impairment of tissue oxygen supply when the oxygen delivery has dropped to critical values. Obstruction of the upper or lower airways are immediately detected and differentiated. Disregulations of metabolism, e.g. in malignant hyperthermia, are seen in a pre-crisis phase (increase of oxygen consumption and of CO2 production), and therapy can be started extremely early and before a disastrous condition has developed. Registration of compliance is only one of the continuously available parameters that guarantee a better and adequate control of lung function (e.g. atalectasis is early detected). The newly developed sophisticated anesthesia device enlarges tremendously the monitoring and respiratory diagnostic possibilities of artificial ventilation, gives new insights in the (patho)physiology and detects disturbances of respiratory parameters and metabolism in an early stage. PMID:2260424

  9. Diagnosing & Treating Digestive Tract Disorders Endoscopically

    Medline Plus

    Full Text Available ... screen, and open the door to informed medical care. Now, let's join the doctors. 00:00:50 ... what we call MAC, which is monitored anesthesia care. And that allows us to do a lot ...

  10. Isoflurane anesthesia is a valuable alternative for alpha-chloralose anesthesia in the forepaw stimulation model in rats.

    NARCIS (Netherlands)

    Sommers, M.G.J.; Egmond, J. van; Booij, L.H.D.J.; Heerschap, A.

    2009-01-01

    Isoflurane (ISO) can be a valuable alternative for alpha-chloralose (ACL) anesthesia in functional MRI (fMRI) studies. Therefore, we compared the efficacy of the blood oxygen level dependent (BOLD) effect in fMRI studies during ISO and ACL anesthesia sequentially in the same animals. After non-invas

  11. Construction of Perioperative Anesthesia Management Security System%围术期手术麻醉管理安全体系的构建

    Institute of Scientific and Technical Information of China (English)

    詹莎莎; 刘炳信

    2016-01-01

    Perioperative patients require anesthesia, as medical technology continues to progress, after anesthesia, the pa-tient's safety are increasing, but the management of security perioperative anesthesia still faces many challenges. With the change of medical model to improve the quality of care, reduce health care costs become the primary purpose. Thus, in ad-dition to the initiative to change, regulate medical practices, the anesthesiologist should strengthen perioperative anesthesia safety management system in order to build a safer surgical patients throughout the medical procedure in anesthesia manage-ment.%患者在围术期需要进行手术麻醉,随着医学技术不断进步,在麻醉后,患者的安全性也不断增加,但围术期的麻醉管理安全仍然面临多项挑战。伴随着医疗模式的改变,提高医疗质量、降低医疗成本成为了首要目的。因此,除了主动改变,规范医疗行为,麻醉医师还应加强患者的围术期麻醉的安全管理,从而构建患者在整个手术医疗过程中麻醉管理的安全体系。

  12. MAC-Bridging for Multi-PHYs Communication in BAN

    Directory of Open Access Journals (Sweden)

    Kyung Sup Kwak

    2010-11-01

    Full Text Available Body Area Network (BAN is a collection of low-power, miniaturised, and intelligent sensor nodes that are used for unobtrusive and ambulatory health monitoring of a patient without any additional constraints. These nodes operate on different frequency bands or Multiple Physical Layers (Multi-PHYs. Additionally, some BAN applications demand a logical connection between different nodes working on different Multi-PHYs. In this paper, the idea of controlling Multi-PHYs using one MAC protocol is introduced. Unlike existing procedures where different nodes working on different channels are connected at the link layer bridging/switching, the proposed procedure called bridging logically connects them at the MAC layer. In other words, the bridge is used to relay or filter packets between different PHYs in the same BAN. Numerical approximations are presented to analyze the stochastic behaviour of the bridges, all of them having Multi-PHYs interfaces. The MICS and the ISM bands are regarded as PHY1 and PHY2, respectively. The performance results are presented for PHY2 (given that data is already received from PHY1 in terms of probability of successful transmission, number of failed requests, power consumption, and delay. Simulations are conducted to validate the analytical results. It can be seen that the deployment of multiple bridges along with the corresponding nodes allows Multi-PHYs communication with high transmission probability, low power consumption, and tolerable delay.

  13. Is Kyoto Fatally Flawed? An Analysis with MacGEM

    International Nuclear Information System (INIS)

    In this paper we present some numerical simulations with the MacGEM model to evaluate the consequences of the recent Marrakesh agreements and the defection of the USA for the Kyoto Protocol. MacGEM is a global marginal abatement cost model for carbon emissions from fossil fuel use based on the GEM-E3-World general equilibrium. Nonparticipation of the USA causes the equilibrium carbon price in Annex B countries to fall by approximately 50% since an important share of permit demand falls out. Carbon sinks enhancement activities enable Parties to fulfil their reduction commitment at lower compliance costs and cause the equilibrium permit price to decrease by 40%. Finally, it is shown that the former Soviet Union and central European countries have substantial monopoly power in the Kyoto carbon permit market. We conclude that the recent accords have eroded completely the Kyoto Protocol's emission targets but that they have the merit to have saved the international climate change negotiation framework

  14. Ímynd M.A.C. Cosmetics

    OpenAIRE

    Ásrún Ísleifsdóttir 1991

    2016-01-01

    Í þessari ritgerð er ímynd M.A.C Cosmetics könnuð. Snyrtivöruiðnaðurinn hefur lengi verið til staðar en þó aldrei verið jafn vinsæll og í dag. Förðunarfræðingum og förðunarskólum fer ört fjölgandi og aukning í kaupum á snyrtivörum helst í hendur við þá fjölgun. Þessar staðreyndir valda því að samkeppnin á snyrtivörumarkaðnum er mikil og ímynd snyrtivörumerkja hefur aldrei verið jafn mikilvæg og nú. M.A.C Cosmetics er gríðarlega vinsælt snyrtivörumerki um heim allan og vinsældir þess gera ...

  15. Learning Microsoft Excel 2011 for Mac video training DVD

    CERN Document Server

    Vaccaro, Guy

    2011-01-01

    In this video tutorial for Microsoft Excel 2011 For Mac, expert author Guy Vaccaro teaches you to effectively utilize the features and functions of Excel through project based learning. You will complete various projects, and along they way learn to leverage the power of the most important features Excel 2011 has to offer the Mac user. Starting your training course with the creation of a spreadsheet to record and monitor sales data, you will learn the basics of what you can do with a spreadsheet. You will then move on to creating a Profit and Loss report, learning formulas along the way. Moving to score sheets for a sports day, you will discover conditional based formatting, lookups, and more. You then create a functional expense claim form, advancing your Excel expertise. Moving on to a sales contact management sheet, you will discover how you can manipulate text, and even create mail merges from Excel. Finally, you will utilize all your knowledge thus far to create a sales report, including charts, pivot ta...

  16. Applying healthcare failure mode and effect analysis to patient pain management in the anesthesia recovery period

    Institute of Scientific and Technical Information of China (English)

    Zhao-Ping Xue; Hong-Yan Li; Rui-Tong Guan; Si Chen

    2016-01-01

    Objective: To standardize pain management in the anesthesia recovery period and improve the effects of analgesia on acute postoperative pain. Methods: Using healthcare failure mode and effect analysis (HFMEA), we analyzed the primary cause of patients' pain and subsequently determined the process and risk priority number (RPN). Results: Actions were taken to improve patients' pain. After using HFMEA, the experimental group's visual analog scale (VAS) scores were lower than those of the control group at 1 h and at discharge from the post-anesthetic intensive care unit (PAICU). The differences were statistically significant (P Conclusions: The application of failure mode and effect analysis can relieve pain and improve the quality of nursing.

  17. Society of Anesthesia and Sleep Medicine Guidelines on Preoperative Screening and Assessment of Adult Patients With Obstructive Sleep Apnea.

    OpenAIRE

    Chung, F; Memtsoudis, SG; Ramachandran, SK; Nagappa, M; Opperer, M; Cozowicz, C; Patrawala, S; Lam, D.; Kumar, A; Joshi, GP; Fleetham, J; Ayas, N; Collop, N; Doufas, AG; Eikermann, M

    2016-01-01

    The purpose of the Society of Anesthesia and Sleep Medicine guideline on preoperative screening and assessment of adult patients with obstructive sleep apnea (OSA) is to present recommendations based on the available clinical evidence on the topic where possible. As very few well-performed randomized studies in this field of perioperative care are available, most of the recommendations were developed by experts in the field through consensus processes involving utilization of evidence grading...

  18. Human Factors Research in Anesthesia Patient Safety: Techniques to Elucidate Factors Affecting Clinical Task Performance and Decision Making

    OpenAIRE

    Weinger, Matthew B.; Slagle, Jason

    2002-01-01

    Patient safety has become a major public concern. Human factors research in other high-risk fields has demonstrated how rigorous study of factors that affect job performance can lead to improved outcome and reduced errors after evidence-based redesign of tasks or systems. These techniques have increasingly been applied to the anesthesia work environment. This paper describes data obtained recently using task analysis and workload assessment during actual patient care and the use of cognitive ...

  19. Serum Mac-2 binding protein is a novel biomarker for chronic pancreatitis

    Science.gov (United States)

    Maekawa, Tomohiro; Kamada, Yoshihiro; Ebisutani, Yusuke; Ueda, Makiko; Hata, Tomoki; Kawamoto, Koichi; Takamatsu, Shinji; Mizutani, Kayo; Shimomura, Mayuka; Sobajima, Tomoaki; Fujii, Hironobu; Nakayama, Kotarosumitomo; Nishino, Kimihiro; Yamada, Makoto; Kumada, Takashi; Ito, Toshifumi; Eguchi, Hidetoshi; Nagano, Hiroaki; Miyoshi, Eiji

    2016-01-01

    AIM: To determine the efficacy of Mac-2 binding protein (Mac-2bp) for diagnosis of chronic pancreatitis. METHODS: Fifty-nine healthy volunteers (HV), 162 patients with chronic pancreatitis (CP), and 94 patients with pancreatic ductal adenocarcinoma (PDAC) were enrolled in this study. We measured serum Mac-2bp using our developed enzyme-linked immunosorbent assay kit. Additional biochemical variables were measured using an automated analyzer (including aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, triglyceride, C-reactive protein, and amylase levels) or chemiluminescent enzyme immunoassay (carbohydrate antigen 19-9 and carcinoembryonic antigen). The ability of Mac-2bp to predict CP diagnosis accurately was assessed using receiver operating characteristic (ROC) analyses. RESULTS: Serum Mac-2bp levels were significantly increased in CP patients compared to HV (P < 0.0001) and PDAC patients (P < 0.0001). Area under the ROC curve values of Mac-2bp for the discrimination of CP from HV and PDAC were 0.727 and 0.784, respectively. Multivariate analyses demonstrated that serum Mac-2bp levels were independent determinants for CP diagnosis from HV and PDAC patients. Immunohistological staining showed that Mac-2bp was expressed faintly in the pancreas tissues of both CP and PDAC patients. Serum aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, and triglyceride levels were significantly higher in patients with CP or PDAC. Serum Mac-2bp levels were highly correlated with protein levels of alanine aminotransferase, γ-glutamyltransferase, and C-reactive protein, but not amylase, suggesting that the damaged liver produces Mac-2bp. CONCLUSION: Measurement of serum Mac-2bp may be a novel and useful biomarker for CP diagnosis as well as liver fibrosis in the general population. PMID:27158210

  20. Brief anesthesia by isoflurane alters plasma corticosterone levels distinctly in male and female rats: Implications for tissue collection methods.

    Science.gov (United States)

    Bekhbat, Mandakh; Merrill, Liana; Kelly, Sean D; Lee, Vanessa K; Neigh, Gretchen N

    2016-05-15

    Euthanasia by anesthetic agents is commonly performed prior to tissue collection in order to minimize pain and distress to the animal. However, depending on their mechanism of action as well as administration regimen, different methods of anesthesia may trigger an acute stress response through engaging the hypothalamic-pituitary-adrenal (HPA) axis, which can impact numerous other physiological processes that the researcher may wish to examine as endpoints. We investigated the effects of the commonly used anesthetic agent isoflurane on two different endpoints related to the stress response: plasma corticosterone levels and gene expression of the glucocorticoid receptor (GR) as well as several of its regulators including FK506-binding protein 51 (Fkbp5) in the hippocampus of male and female rats. Our results indicate that brief exposure to anesthesia by isoflurane prior to decapitation can alter plasma corticosterone levels differentially in male and female rats within minutes without impacting gene expression in the hippocampus. We conclude that collection methods can influence stress-related physiological endpoints in female rats and the potential influence of even brief anesthesia as well as sex differences in response to anesthesia should be evaluated during the experimental design process and data interpretation. This finding is particularly important in light of new NIH standards regarding sex and reproducibility, and care should be taken to be certain that sex differences in endpoints of interest are not an artifact of sex differences in response to collection paradigms. PMID:26946276

  1. COMPARATIVE STUDY OF SPINAL ANESTHESIA AND GENERAL ANESTHESIA IN CHILDREN UNDERGOING SURGERIES BELOW UMBILICUS

    Directory of Open Access Journals (Sweden)

    Ashish

    2014-09-01

    Full Text Available AIM: Aim of our study to compare the spinal anaesthesia and general anaesthesia in children undergoing surgeries below umbilicus. OBJECTIVE: to assess the patient comfort in pt. with GA and pt. with spinal anaesthesia, the adequate surgical condition, assess the hemodynamic change, assess the post op analgesia and to assess the post op complication. MATERIAL AND METHOD: 60 ASA grade I & II children of either sex, aged 5-12 yrs undergoing elective surgeries for the lower abdominal, perineal and lower limb surgeries were taken. After taking a detailed history, thorough general physical examination, all pertinent investigation were carried out to exclude any systemic disease. Patients were classified randomly into 2 groups (30 patients in each group. Group A: General anesthesia was given. Group P: subarachnoid block was given. Intraoperative monitoring consisted of SPO2, PR, NIBP, RR and assessment of duration of post-operative analgesia. P-value <0.05 consider significant. RESULT: Analysis revealed that there were no significant differences between the patients with respect to age, sex, duration and type of surgery In SAB since less general anaesthetic drug including parental opioid are used the risk and postoperative respiratory depression is minimal. The stress response to surgery is also limited and recovery is fast. Postoperatively complications like sore throat, laryngeal irritation, cough etc. was also less associated with it. CONCLUSION pediatric spinal anesthesia is not only a safe alternative to general anesthesia but often the anesthesia technique of choice in many lower abdominal and lower limb surgeries in children. The misconception regarding its safety and flexibility is broken and is now found to be even more cost effective. It is much preferred technique special for common day case surgeries generally performed in the pediatric age group.

  2. FF-MAC : Fast Forward IEEE 802.15.4 MAC Protocol for Real-Time Data Transmission

    Directory of Open Access Journals (Sweden)

    Khalid EL GHOLAMI

    2013-02-01

    Full Text Available This paper presents a Fast Forward MAC layer designed for hard real-time applications in wireless sensor networks. This protocol is an enhancement to the IEEE 802.15.4 standard MAC layer proposed for Low-Rate Personal Area Network. The energy conservation mechanism proposed by the current standard is quite efficient and very flexible. This flexibility comes from the ability to configure different duty cycles to meet specific application’s requirements. However, this mechanism has a considerable impact on the end-to-end delay. Our approach resolves the energy delay trade-off by avoiding the storage of the real-time data in the coordinator during sleep time.A new superframe structure is adopted and a deterministic reception scheduling is used. All the simulations were done using the network simulator 2 ‘NS-2’. The simulations outcomes show that this new proposed protocol performs better than the currentstandard and reduces considerably the end-to-end delay even in low duty cycle networks. Our protocol can also provide a delay bound for all network configurations which allows a better choice of the duty cycle for the required delay.

  3. Tissue microcirculation measured by vascular occlusion test during anesthesia induction.

    Science.gov (United States)

    Kim, Tae Kyong; Cho, Youn Joung; Min, Jeong Jin; Murkin, John M; Bahk, Jae-Hyon; Hong, Deok Man; Jeon, Yunseok

    2016-02-01

    Tissue microcirculation measured by vascular occlusion test is impaired during septic shock. However, it has not been investigated extensively during anesthesia induction. The aim of the study is to evaluate tissue microcirculation during anesthesia induction. We hypothesized that during anesthesia induction, tissue microcirculation measured by vascular occlusion test might be enhanced with peripheral vasodilation during anesthesia induction. We conducted a prospective observational study of 50 adult patients undergoing cardiac surgery. During anesthesia induction, we measured and analyzed tissue oxygen saturation, vascular occlusion test, cerebral oximetry, forearm-minus-fingertip skin temperature gradients and hemodynamic data in order to evaluate microcirculation as related to alterations in peripheral vasodilation as reflected by increased Tforearm-finger thermal gradients. During anesthesia induction, recovery slope during vascular occlusion test and cerebral oxygen saturation increased from 4.0 (1.5) to 4.7 (1.3) % s(-1) (p = 0.02) and 64.0 (10.2) to 74.2 (9.2) % (p Forearm-minus-fingertip skin temperature gradients decreased from 1.9 (2.9) to -1.4 (2.2) °C (p blood pressure and forearm-minus-fingertip skin temperature gradients decrease while cerebral oximetry and vascular occlusion test recovery slope increase. These findings suggest that anesthesia induction increases tissue microcirculation with peripheral vasodilation. PMID:25750016

  4. General Anesthesia for a Patient With Pelizaeus-Merzbacher Disease.

    Science.gov (United States)

    Kamekura, Nobuhito; Nitta, Yukie; Takuma, Shigeru; Fujisawa, Toshiaki

    2016-01-01

    We report the successful management of general anesthesia for a patient with Pelizaeus-Merzbacher disease (PMD). PMD is one of a group of progressive, degenerative disorders of the cerebral white matter. The typical clinical manifestations of PMD include psychomotor retardation, nystagmus, abnormal muscle tone, seizures, and cognitive impairment. General anesthesia for a patient with PMD may be difficult mainly because of seizures and airway complications related to poor pharyngeal muscle control. In addition, the possibility of exacerbation of spasticity should be considered. A 20-year-old man with PMD required removal of impacted wisdom teeth under general anesthesia. General anesthesia was induced with thiamylal, fentanyl, and desflurane. Anesthesia was maintained with desflurane and continuous intravenous remifentanil under bispectral index and train-of-4 monitoring. Anesthesia lasted 1 hour 20 minutes and was completed uneventfully. Airway complications, seizures, and exacerbation of spasticity did not occur postoperatively. Preoperatively, our patient had no history of epilepsy attacks or aspiration pneumonia, and no clinical symptoms of gastroesophageal reflux disease. Therefore, exacerbation of spasticity was one of the most likely potential complications. Identification of these associated conditions and evaluation of risk factors during preoperative examination is important for performing safe anesthesia in these patients. PMID:27269667

  5. Total spinal anesthesia in an achondroplasic patient: case report

    Directory of Open Access Journals (Sweden)

    Amiri H R

    2008-06-01

    Full Text Available Background: Total spinal anesthesia is a complication of lumbar epidural anesthesia following undiagnosed subarachnoid or subdural injection of local anesthetic. Although many achondroplastic dwarfs have a normal spine, catheter insertion may be more problematic with a narrow epidural space making a subarachnoid tap more probable.  Other malformations associated with achondroplasia, such as prolapsed intervertebral discs, reduced interpedicular distance, shortened pedicles, and osteophyte formation, combined with a narrow epidural space may make identification of the space difficult and increases the risk of dural puncture. Furthermore, subarachnoid tap or dural puncture may be hard to recognize if a free flow of CSF is difficult to achieve due spinal stenosis. Yet, for those who meet the criteria, epidural regional anesthesia is frequently preferred over other forms, which often have more or more dangerous side effects in this type of patient.Case report: A 22-year-old achondroplastic male dwarf patient was scheduled for pelvic mass resection and was considered a candidate for continuous epidural anesthesia. The anesthesia became complicated by total spinal anesthesia, which was reversed following supportive management for about two hours.Conclusion: There is significant debate over the composition and volume of the test dose, especially for patients with achondroplasia. We nevertheless recommend repeated test-doses during the accomplishment of epidural anesthesia to exclude unintended intravascular, intrathecal or subdural injection, keeping in mind that a test dose of local anesthetic does not completely prevent complications.

  6. The effect of hypernatremic state on anesthesia: male Wistar rat

    Directory of Open Access Journals (Sweden)

    Heydarpour F, Rostami A, Alipour M, Amini B, Heydarpour P

    2008-07-01

    Full Text Available "nBackground: The function of internal systems can be influenced significantly by hypernatremia, even anesthesia may be affected by this electrolyte imbalance. The aim of this study was to determine the effects of a single anesthetic dose of ketamine in an experimental rat model of chronic hypernatremia. "n"nMethods: Sixty male Wistar rats, weighing 300(±20g, were allocated randomly to three groups: the control group received drinking water and test groups 1 and 2 received 1% and 2% NaCl, respectively, for 144 hours. We measured the parameters of sensitivity to the ketamine injection (125mg/kg including length of times to the inhibition of the righting reflex, inhibition of the response to painful stimulus and the times to the reappearance of the response to painful stimulus and recovery from anesthesia. We also determined the mortality rates during anesthesia. "n"nResults: The times for inhibition of the righting reflex and response to painful stimulus for group 2 were significantly shorter than those for group 1 and the control group. The times for the reappearance of response to painful stimulus and full recovery from anesthesia in group 2 were significantly longer than those of group 1 and the control group. "n"nConclusions: Hypernatremia affects ketamine anesthesia in the rat, increasing the speed of passing through the different steps of anesthesia. The duration of ketamine efficacy increases, while recovery from anesthesia is significantly delayed.

  7. Management of comorbidities in ambulatory anesthesia: a review

    Directory of Open Access Journals (Sweden)

    Dabu-Bondoc S

    2015-06-01

    Full Text Available Susan Dabu-Bondoc, Kirk Shelley Department of Anesthesiology, School of Medicine, Yale University, New Haven, CT, USAAbstract: Advances in medical science now allow people with significant medical issues to live at home. As the outpatient population ages and surgical techniques advance, the ambulatory anesthesiologist has to be prepared to handle these “walking wounded”. The days of restricting ambulatory surgery procedures to American Society of Anesthesiologists class 1 and 2 patients are rapidly fading into the past. To remain competitive and economically viable, the modern ambulatory surgery center needs to expand its practice to include patients with medical comorbidities. In an environment where production and economic pressures exist, maintaining safety and good outcomes in high-risk patients for ambulatory surgery can be arduous. Adding to the complexity of this challenge is the rapid evolution of the therapeutic approaches to a variety of medical issues. For example, there has been a significant increase in the number and types of insulin a diabetic patient might be prescribed in recent years. In the case of the patient with coronary artery disease, the variety of both drug and nondrug eluding stents or new antithrombotic agents has also increased the complexity of perioperative management. Complex patients need careful, timely, and team-based preoperative evaluation by an anesthesia provider who is knowledgeable of outpatient care. Optimizing comorbidities preoperatively is a crucial initial step in minimizing risk. This paper will examine a number of common medical issues and explore their impact on managing outpatient surgical procedures.Keywords: ambulatory surgery, medical comorbidities, diabetes, coronary artery disease, respiratory disease, obesity

  8. Behavior Assessment in Children Following Hospital-Based General Anesthesia versus Office-Based General Anesthesia

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    LaQuia A. Vinson

    2016-08-01

    Full Text Available The purpose of this study was to determine if differences in behavior exist following dental treatment under hospital-based general anesthesia (HBGA or office-based general anesthesia (OBGA in the percentage of patients exhibiting positive behavior and in the mean Frankl scores at recall visits. This retrospective study examined records of a pediatric dental office over a 4 year period. Patients presenting before 48 months of age for an initial exam who were diagnosed with early childhood caries were included in the study. Following an initial exam, patients were treated under HBGA or OBGA. Patients were followed to determine their behavior at 6-, 12- and 18-month recall appointments. Fifty-four patients received treatment under HBGA and 26 were treated under OBGA. OBGA patients were significantly more likely to exhibit positive behavior at the 6- and 12-month recall visits p = 0.038 & p = 0.029. Clinicians should consider future behavior when determining general anesthesia treatment modalities in children with early childhood caries presenting to their office.

  9. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Science.gov (United States)

    2010-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent anesthesia services...

  10. 42 CFR 414.46 - Additional rules for payment of anesthesia services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Additional rules for payment of anesthesia services... Physicians and Other Practitioners § 414.46 Additional rules for payment of anesthesia services. (a... each anesthesia code that reflects all activities other than anesthesia time. These activities...

  11. Lack of effect of spinal anesthesia on drug metabolism

    International Nuclear Information System (INIS)

    The effect of spinal anesthesia on drug disposition was determined in six dogs with chronically implanted vascular catheters using propranolol as a model compound. On the first study day, 40 mg of unlabeled propranolol and 200 microCi of [3H]propranolol were injected into the portal and femoral veins respectively. Arterial blood samples were taken for 4 hr for measurement of plasma concentrations of labeled and unlabeled propranolol by high-pressure liquid chromatography (HPLC) and of [3H]propranolol by liquid scintillation counting of the HPLC eluant corresponding to each propranolol peak. Twenty-four hr later, spinal anesthesia was induced with tetracaine (mean dose 20.7 +/- 0.6 mg) with low sacral to midthoracic levels and the propranolol infusions and sampling were then repeated. Spinal anesthesia had no significant effect on either the intrinsic clearance of propranolol (2.01 +/- 0.75 L/min before and 1.9 +/- 0.7 L/min during spinal anesthesia), or on mean hepatic plasma flow (2.01 +/- 0.5 L/min before and 1.93 +/- 0.5 L/min during spinal anesthesia). The systemic clearance and elimination half-life of propranolol were also unchanged by spinal anesthesia (0.9 +/- 0.23 L/min on the first day, 0.7 +/- 0.1 L/min during spinal anesthesia; and 101 +/- 21 min on the first day, 115 +/- 16 min during spinal anesthesia, respectively). The volume of distribution (Vd) of propranolol was similarly unaffected by spinal anesthesia

  12. Propofol alternatives in gastrointestinal endoscopy anesthesia

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    Basavana Gouda Goudra

    2014-01-01

    Full Text Available Although propofol has been the backbone for sedation in gastrointestinal endoscopy, both anesthesiologists and endoscopists are faced with situations where an alternative is needed. Recent national shortages forced many physicians to explore these options. A midazolam and fentanyl combination is the mainstay in this area. However, there are other options. The aim of this review is to explore these options. The future would be, invariably, to move away from propofol. The reason is not in any way related to the drawbacks of propofol as a sedative. The mandate that requires an anesthesia provider to administer propofol has been a setback in many countries. New sedative drugs like Remimazolam might fill this void in the future. In the meantime, it is important to keep an open eye to the existing alternatives.

  13. TONSILLECTOMY UNDER LOCAL ANESTHESIA IN MALI

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    SACKO HB

    2015-04-01

    Full Text Available BACKGROUND The objective of this study was to analyze a series of tonsillectomies performed in the ENT Reference CentreoftheHealth, DistrictIVBAMAKOMALI PATIENTS and METHODS The study was conducted between June 2003 and May 2013 focused on 166 patients. Patients with chronic tonsillitis, obstructive hypertrophy of the Palatine tonsils, caseous tonsillitis were included in the study. The method of dissection of the tonsils in sitting position (home position was the technique used. RESULTS A predominance of female 114 (68.70% were observed. The average age of the patients was 25 years with extremes from 12 to 54 years. Tonsillectomy was bilateral in all patients of the study. The main indications were: chronic tonsillitis 101 (60.84%. There was no major complication during the postoperative period. CONCLUSION Tonsillectomy under local anesthesia is well tolerated by patients in a tropical environment. Its cost is less.

  14. AAHA anesthesia guidelines for dogs and cats.

    Science.gov (United States)

    Bednarski, Richard; Grimm, Kurt; Harvey, Ralph; Lukasik, Victoria M; Penn, W Sean; Sargent, Brett; Spelts, Kim

    2011-01-01

    Safe and effective anesthesia of dogs and cats rely on preanesthetic patient assessment and preparation. Patients should be premedicated with drugs that provide sedation and analgesia prior to anesthetic induction with drugs that allow endotracheal intubation. Maintenance is typically with a volatile anesthetic such as isoflurane or sevoflurane delivered via an endotracheal tube. In addition, local anesthetic nerve blocks; epidural administration of opioids; and constant rate infusions of lidocaine, ketamine, and opioids are useful to enhance analgesia. Cardiovascular, respiratory, and central nervous system functions are continuously monitored so that anesthetic depth can be modified as needed. Emergency drugs and equipment, as well as an action plan for their use, should be available throughout the perianesthetic period. Additionally, intravenous access and crystalloid or colloids are administered to maintain circulating blood volume. Someone trained in the detection of recovery abnormalities should monitor patients throughout recovery. Postoperatively attention is given to body temperature, level of sedation, and appropriate analgesia. PMID:22058343

  15. STUDY OF INJECTION TRAMADOL AS ADDITIVE IN INTRAVENOUS REGIONAL ANESTHESIA

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    Rajesh

    2015-10-01

    Full Text Available Now a days IVRA is developed with use of double tourniquet and additive drugs like opioids, NSAIDS , muscle relaxants etc ., to minimize the intraoperative discomfort of surgery and tourniquet pain. Many additives can take care of the post - operative pain. Each additive has its own pros and cons. Tramadol is a synthetic opioid analgesic having additional local anesthetic propert y and effect in neurotransmitter reuptake. With this background we studied the injection Tramadol 50mg as additive in IVRA against control group. METHODOLOGY : All the selected patients are from ASA Grade 1 and 2 for surgical procedure of upper limb. We hav e excluded the cases which are contraindicated for tourniquet and patients who are uncooperative and allergic to drug used for study. All 50 patients are divided in two groups. Group 1 - 25 patients who receive Intravenous Regional Anesthesia with injection lignocaine 0.5% 40cc volume. Group 2 - 25 patients who receive Intravenous Regional Anesthesia with injection Tramadol 50mgand injection lignocaine 0.5% total40ccvolume. After the drug is loaded in venous compartment sensory blocked is assessed at the interva l of one min. by blunt needle pin pricks in all dermatome segments by using a 3 - point scale: 0 = normal sensation, 1 = loss of sensation of pin prick ( A nalgesia, and 2 = loss of sensation of touch ( A nesthesia. Motor block is assessed at the interval of t wo min. Motor block was determined according to the modified Bromage scale. It is on 3 point assessment i.e. , thumb abduction (Radial nerve, thumb adduction ( U lnar nerve, thumb opposition ( M edian nerve, and flexion of elbow ( M usculocutaneous nerve OBSE RVATIONS : we observed onset of sensory blockade, onset of motor blockade , intraoperative discomfort, postoperative analgesia and postoperative nausea vomiting. Onset of sensory blockade is significantly rapid in group2 ( I njection lignocaine + injection Tramadol group (p - 0.00001 whereas there

  16. 78 FR 65145 - Federal Agricultural Mortgage Corporation Funding and Fiscal Affairs; Farmer Mac Capital Planning

    Science.gov (United States)

    2013-10-31

    ... distributions before making them. \\1\\ 78 FR 5320. II. Background A. Farmer Mac Farmer Mac is an institution of... Plans, 76 FR 74631 (December 1, 2011); the FRS's proposed rule, Enhanced Prudential Standards and Early Remediation Requirements for Covered Companies, 77 FR 594 (January 5, 2012); the U.S. banking agencies'...

  17. 75 FR 27951 - Federal Agricultural Mortgage Corporation Funding and Fiscal Affairs; Farmer Mac Investments and...

    Science.gov (United States)

    2010-05-19

    .... 2279aa-2279cc et seq.) \\2\\ See section 8.13 of the Act. A fundamental premise of finance is the natural... purpose embedded in its corporate mission that arises from having been created by an act of Congress. The... by Farmer Mac, are known as the ``Farmer Mac II'' program. During 2008, the markets in corporate...

  18. HYBRID MAC PROTOCOL FOR WIRELESS SENSOR NETWORKS USED IN TIME CRITICAL APPLICATIONS

    Directory of Open Access Journals (Sweden)

    Pandeeswaran Chelliah

    2014-05-01

    Full Text Available In this paper a H-MAC protocol (Hybrid Medium Access Control protocol has been proposed, which is an energy efficient and low latency MAC protocol which uses node ID method to assign priority for certain wireless sensor nodes that are assumed to be present in critical loops for an industrial process control domain. H-MAC overcomes some of the limitations in the existing approaches. In the case of industrial automation scenario, certain sensor loops are found to be time critical, where data’s have to be transferred without any further delay, as failure in immediate transmission leads to catastrophic results for humans as well as machinery in industrial domain. The proposed H-MAC protocol is simulated in NS2 environment, from the result it is observed that the proposed protocol provides better performance compared to the conventional MAC protocols mentioned in the recent literature for the conceded problem. A MAC protocol which provides both energy saving mechanism and that can handle emergency situation is the most desired for any industry. In any industry time and mission critical scenarios requires strict timeliness and reliability along with the energy efficiency. However there are dynamic and harsh environmental conditions for which the MAC protocol must survive and do transmission accordingly. The dynamic changes in topology must also be adapted so that the nodes are in constant link to the destination. Most of the existing MAC protocols have been identified as they face a number of limitations for industrial application domain.

  19. Geochemistry and petrography of the MacAlpine Hills lunar meteorites

    Science.gov (United States)

    Lindstrom, Marilyn M.; Mckay, David S.; Wentworth, Susan J.; Martinez, Rene R.; Mittlefehldt, David W.; Wang, Ming-Sheng; Lipschutz, Michael E.

    1991-01-01

    MacAlpine Hills 88104 and 88105, anorthositic lunar meteorites recovered form the same area in Antartica, are characterized. Petrographic studies show that MAC88104/5 is a polymict breccia dominated by impact melt clasts. It is better classified as a fragmental breccia than a regolith breccia. The bulk composition is ferroan and highly aluminous (Al2O3-28 percent).

  20. Scheduled MAC in Beacon Overlay Networks for Underwater Localization and Time-Synchronization

    NARCIS (Netherlands)

    Kleunen, van Wouter; Meratnia, Nirvana; Havinga, Paul J.M.

    2011-01-01

    In this article we introduce a MAC protocol designed for underwater localization and time-synchronisation. The MAC protocol assumes a network of static reference nodes and allows blind nodes to be localized by listening-only to the beacon messages. Such a system is known to be very scalable. We show