排序方式: 共有36条查询结果,搜索用时 15 毫秒
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Healey JS Merchant R Simpson C Tang T Beardsall M Tung S Fraser JA Long L van Vlymen JM Manninen P Ralley F Venkatraghavan L Yee R Prasloski B Sanatani S Philippon F;Canadian Cardiovascular Society;Canadian Anesthesiologists' Society;Canadian Heart Rhythm Society 《The Canadian journal of cardiology》2012,28(2):141-151
There are more than 200,000 Canadians living with permanent pacemakers or implantable defibrillators, many of whom will require surgery or invasive procedures each year. They face potential hazards when undergoing surgery; however, with appropriate planning and education of operating room personnel, adverse device-related outcomes should be rare. This joint position statement from the Canadian Cardiovascular Society (CCS) and the Canadian Anesthesiologists' Society (CAS) has been developed as an accessible reference for physicians and surgeons, providing an overview of the key issues for the preoperative, intraoperative, and postoperative care of these patients. The document summarizes the limited published literature in this field, but for most issues, relies heavily on the experience of the cardiologists and anesthesiologists who contributed to this work. This position statement outlines how to obtain information about an individual's type of pacemaker or implantable defibrillator and its programming. It also stresses the importance of determining if a patient is highly pacemaker-dependent and proposes a simple approach for nonelective evaluation of dependency. Although the document provides a comprehensive list of the intraoperative issues facing these patients, there is a focus on electromagnetic interference resulting from electrocautery and practical guidance is given regarding the characteristics of surgery, electrocautery, pacemakers, and defibrillators which are most likely to lead to interference. The document stresses the importance of preoperative consultation and planning to minimize complications. It reviews the relative merits of intraoperative magnet use vs reprogramming of devices and gives examples of situations where one or the other approach is preferable. 相似文献
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Development of White Matter Hyperintensity Is Preceded by Reduced Cerebrovascular Reactivity
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Jeff S. Healey MD Richard Merchant MD Chris Simpson MD Timothy Tang MD Marianne Beardsall MN/NP Stanley Tung MD Jennifer A. Fraser RN Laurene Long RN Janet M. van Vlymen MD Pirjo Manninen MD Fiona Ralley MBBCh Lashmi Venkatraghavan MD Raymond Yee MD Bruce Prasloski MD Shubhayan Sanatani MD Fran?ois Philippon MD 《Journal canadien d'anesthésie》2012,59(4):394-407
Purpose
There are more than 200,000 Canadians living with permanent pacemakers or implantable defibrillators, many of whom will require surgery or invasive procedures each year. They face potential hazards when undergoing surgery; however, with appropriate planning and education of operating room personnel, adverse device-related outcomes should be rare. This joint position statement from the Canadian Cardiovascular Society (CCS) and the Canadian Anesthesiologists?? Society (CAS) has been developed as an accessible reference for physicians and surgeons, providing an overview of the key issues for the preoperative, intraoperative, and postoperative care of these patients.Principal findings
The document summarizes the limited published literature in this field, but for most issues, relies heavily on the experience of the cardiologists and anesthesiologists who contributed to this work. This position statement outlines how to obtain information about an individual??s type of pacemaker or implantable defibrillator and its programming. It also stresses the importance of determining if a patient is highly pacemaker-dependent and proposes a simple approach for nonelective evaluation of dependency. Although the document provides a comprehensive list of the intraoperative issues facing these patients, there is a focus on electromagnetic interference resulting from electrocautery and practical guidance is given regarding the characteristics of surgery, electrocautery, pacemakers, and defibrillators which are most likely to lead to interference.Conclusions
The document stresses the importance of preoperative consultation and planning to minimize complications. It reviews the relative merits of intraoperative magnet use vs reprogramming of devices and gives examples of situations where one or the other approach is preferable. 相似文献6.
Two types of novel chemical drug delivery systems (CDS's) for acyclovir, A-CDS-1 (based on oxidation, which utilized the 1,4-dihydrotrigonelline moiety) and A-CDS-2 (based on reduction, which utilized the lipoic acid moiety), were designed to create reservoirs of metabolic precursors for the enhanced local delivery of the antiviral agent acyclovir to the skin. They were evaluated in two-compartment diffusion cells using hairless-mouse skin in vitro. This approach could be useful in the treatment of mucocutaneous herpes simplex virus (HSV-1) infection in the epidermal region of the skin. Upon application to the freshly excised hairless-mouse skin, A-CDS-1 was rapidly oxidized to form the quaternary metabolite AQ+, which was extensively localized in the skin. AQ+ then served as a reservoir for the release of the antiviral agent in the skin. A-CDS-1 delivered almost equivalent amounts of acyclovir not only to the skin but also transdermally. On the other hand, A-CDS-2 specifically localized acyclovir delivery to the skin as opposed to transdermal delivery. Due to their redox properties, both CDS's demonstrated significant depot formation of metabolic precursors, thus enhancing intradermal acyclovir delivery. The CDS's exhibited greater skin membrane partition coefficients than the parent underivatized acyclovir and were able to release the antiviral agent in the skin tissue. The CDS's were susceptible to hydrolysis in biological media, resulting in the release of acyclovir under near physiological conditions. Thus, the CDS's can serve to enhance intradermal targeting and delivery of the antiviral agent acyclovir. 相似文献
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James Duffin Olivia Sobczyk Adrian Crawley Julien Poublanc Lashmi Venkatraghavan Kevin Sam Alan Mutch David Mikulis Joseph Fisher 《Human brain mapping》2017,38(11):5590-5602
The ability of the cerebral vasculature to regulate vascular diameter, hence resistance and cerebral blood flow (CBF), in response to metabolic demands (neurovascular coupling), and perfusion pressure changes (autoregulation) may be assessed by measuring the CBF response to carbon dioxide (CO2). In healthy individuals, the CBF response to a ramp CO2 stimulus from hypocapnia to hypercapnia is assumed sigmoidal or linear. However, other response patterns commonly occur, especially in individuals with cerebrovascular disease, and these remain unexplained. CBF responses to CO2 in a vascular region are determined by the combined effects of the innate vascular responses to CO2 and the local perfusion pressure; the latter ensuing from pressure‐flow interactions within the cerebral vascular network. We modeled this situation as two vascular beds perfused in parallel from a fixed resistance source. Our premise is that all vascular beds have a sigmoidal reduction of resistance in response to a progressive rise in CO2. Surrogate CBF data to test the model was provided by magnetic resonance imaging of blood oxygen level‐dependent (BOLD) signals. The model successfully generated all the various BOLD‐CO2 response patterns, providing a physiological explanation of CBF distribution as relative differences in the network of vascular bed resistance responses to CO2. Hum Brain Mapp 38:5590–5602, 2017. © 2017 Wiley Periodicals, Inc. 相似文献
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Tze Yeng Yeoh Pirjo Manninen Suneil K. Kalia Lashmi Venkatraghavan 《Journal canadien d'anesthésie》2017,64(3):308-319