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991.
The “hidden” concealed left‐sided accessory pathway: An uncommon cause of SVT in young people
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992.
Anesthesia for subcutaneous implantable cardioverter‐defibrillator implantation: Perspectives from the clinical experience of a U.S. panel of physicians
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Michael K. Essandoh MD George E. Mark MD Johan D. Aasbo DO Charles A Joyner MD Saumya Sharma MD Beningo F Decena MD Eric D Bolin MD Raul Weiss MD Martin C Burke DO Timothy R. McClernon PhD Emile G. Daoud MD Michael R. Gold MD PhD 《Pacing and clinical electrophysiology : PACE》2018,41(7):807-816
1 Background and objective
Worldwide adoption of the subcutaneous implantable cardioverter‐defibrillator (S‐ICD) for preventing sudden cardiac death continues to increase, as longer‐term evidence demonstrating the safety and efficacy of the S‐ICD expands. As a relatively new technology, comprehensive anesthesia guidance for the management of patients undergoing S‐ICD placement is lacking. This article presents advantages and disadvantages of different periprocedural sedation and anesthesia options for S‐ICD implants including general anesthesia, monitored anesthesia care, regional anesthesia, and nonanesthesia personnel administered sedation and analgesia.2 Methods
Guidance, for approaches to anesthesia care during S‐ICD implantation, is presented based upon literature review and consensus of a panel of high‐volume S‐ICD implanters, a regional anesthesiologist, and a cardiothoracic anesthesiologist with significant S‐ICD experience. The panel developed suggested actions for perioperative sedation, anesthesia, surgical practices, and a decision algorithm for S‐ICD implantation.3 Conclusions
While S‐ICD implantation currently requires higher sedation than transvenous ICD systems, the panel consensus is that general anesthesia is not required or is obligatory for the majority of patients for the experienced S‐ICD implanter. The focus of the implanting physician and the anesthesia services should be to maximize patient comfort and take into consideration patient‐specific comorbidities, with a low threshold to consult the anesthesiology team. 相似文献993.
Purpose
Morphine ARER is a novel oral, abuse-deterrent, extended-release (ER) formulation of morphine sulfate with physical and chemical properties that deter misuse and abuse by nonoral routes of administration. Here we evaluate the relative bioavailability of morphine ARER and extended-release morphine.Methods
This single-dose, 2-treatment, 2-period, 2-sequence, randomized crossover study in healthy adult subjects compared the relative bioavailability of morphine ARER 100 mg to that of ER morphine 100 mg in the fasted condition. At 12 and 1.5 hours before dosing and 12 hours after dosing, all subjects received a 50-mg oral naltrexone tablet to minimize opioid-related side effects. Pharmacokinetic parameters including the AUC0–t, AUC0–∞, and Cmax of morphine and its metabolite morphine-6-glucuronide (M6G) were determined at various times up to 48 hours postdose. The bioequivalence of morphine ARER and ER morphine was determined using an ANOVA of the least-squares mean values of morphine and M6G bioavailability.Findings
Forty-nine subjects completed the study. Both morphine ARER and ER morphine exhibited peak plasma morphine and M6G concentrations of ~30 ng/mL and ~200 ng/mL, respectively, at 3 hours postdose. The 90% CIs of the ln-transformed values of morphine AUC0–t, AUC0–∞, and Cmax were within the 80% to 125% range for bioequivalence. M6G values also indicated bioequivalence of morphine ARER and ER morphine. The most common adverse events were nausea and somnolence.Implications
These data show that, in these subjects, morphine ARER was bioequivalent to ER morphine, a treatment for pain with well-established efficacy and safety profiles. 相似文献994.
Janet Prvu Bettger Vu Q.C. Nguyen J. George Thomas Tami Guerrier Qing Yang Mark A. Hirsch Terrence Pugh Gabrielle Harris Mary Ann Eller Carol Pereira Deanna Hamm Eric A. Rinehardt Matthew Shall Janet P. Niemeier 《Archives of physical medicine and rehabilitation》2018,99(6):1226-1231
Attention to health care quality and safety has increased dramatically. The internal focus of an organization is not without influence from external policy and research findings. Compared with other specialties, efforts to align and advance rehabilitation research, practice, and policy using electronic health record data are in the early stages. This special communication defines quality, applies the dimensions of quality to rehabilitation, and illustrates the feasibility and utility of electronic health record data for research on rehabilitation care quality and outcomes. Using data generated at the point of care provides the greatest opportunity for improving the quality of health care, producing generalizable evidence to inform policy and practice, and ultimately benefiting the health of the populations served. 相似文献
995.
996.
997.
Accuracy of fetal sex determination in the first trimester of pregnancy using 3D virtual reality ultrasound
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998.
A randomized trial using telehealth technology to link caregivers with dementia care experts for in‐home caregiving support: FamTechCare protocol
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999.
1000.
Shadi Lahham Brent A. Becker Abdulatif Gari Steven Bunch Maili Alvarado Craig L. Anderson Eric Viquez Sophia C. Spann John C. Fox 《The American journal of emergency medicine》2018,36(6):962-966