Publications by authors named "Engelman E"
Article Synopsis
- A multicenter study compared ultrasound-guided lumbar medial branch block (LMBB) with fluoroscopy-guided LMBB for treating pain from lumbar facet joints.
- Fifty adults were randomly assigned to receive either method and assessed for pain relief and disability using various scales before treatment and at 1 week and 1 month post-procedure.
- Results showed that the ultrasound-guided method was just as effective as fluoroscopy in pain relief and had the added benefit of being irradiation-free, making it a viable alternative.
Background: One of the reasons that high-frequency jet ventilation (HFJV) is used is due to the near immobility of thoracic structures. However, no study has quantified the movements of cardiac structures during HFJV compared with normal mechanical ventilation.
Methods: After ethical approval and written informed consent, we included 21 patients scheduled for atrial fibrillation ablation in this prospective crossover study.
Background & Aims: Acute illness can lead to disability and reduced quality of life in older patients. The aim of this systematic review was to evaluate the effect of nutritional rehabilitation provided during and after hospitalisation for an acute event on functional status, muscle mass, discharge destination and quality of life of older patients.
Methods: The protocol for this systematic review was registered in PROSPERO (CRD42021264971).
Background: Inadequate antinociception can cause haemodynamic instability. The nociception level (NOL) index measures response to noxious stimuli, but its capacity to predict optimal antinociception is unknown.
Objective: To determine if NOL index change to a tetanic stimulus in cardiac and noncardiac surgery patients could predict the required remifentanil concentration for haemodynamic stability at skin incision.
Background: Right Heart Failure (RHF) is a severe complication that can occur after left ventricular assist device (LVAD) implantation, increasing early and late mortality. Although numerous RHF predictive scores have been developed, limited data exist on the external validation of these models. We therefore aimed at comparing existent risk score models and identifying predictors of severe RHF at our center.
View Article and Find Full Text PDFObjectives: To determine if venoarterial extracorporeal membrane oxygenation (VA ECMO) as a bridge to left ventricular assist device (LVAD) in heart transplant (HT) candidates (ie, double bridge to HT) was associated with increased morbidity and mortality when compared to LVAD bridging to HT (ie, single bridge to HT).
Design: A retrospective analysis of patients undergoing LVAD support from 2011 to 2020. A Kaplan-Meier survival curve and Cox-Mantel hazard ratios (HR) were calculated during LVAD support and after HT.
Background: Sugammadex allows for rapid reversal of muscle relaxation after the use of rocuronium or vecuronium. The lowest recommended dose is 2 mg kg-1 intravenously when there are two twitches during the train-of-four stimulation.
Objective: To study the efficacy and risks of a lower dose of sugammadex administered earlier.
Background: The effect of dexmedetomidine on Nociception Level Index-guided (Medasense, Israel) antinociception to reduce intra-operative opioid requirements has not been previously investigated.
Objective: We aimed to determine if low-dose dexmedetomidine would reduce remifentanil requirements during Nociception Level Index-guided antinociception without increasing complications associated with dexmedetomidine.
Design: Double-blind randomised controlled trial.
Article Synopsis
- The study looked at how lidocaine, a type of medicine, might help protect blood vessel layers in patients having major abdominal surgery.
- Researchers tested 40 patients, comparing those who got lidocaine to those who got saline (a salt water solution).
- They found that while surgery increased certain markers related to blood vessel health, lidocaine didn’t seem to make a difference compared to the saline. *
Background: Mismanagement of remifentanil leads to severe side effects such as opioid-induced tolerance and hyperalgesia. Recently studies revealed an alternative withdrawal method to limit these side effects. A gradual withdrawal of remifentanil seems to be associated with less pain.
View Article and Find Full Text PDFRemote Cerebellar Hemorrhage is a rare entity that manifests spontaneously after supratentorial craniotomy and spinal surgeries. We present a 53-year-old male who was admitted due to subdural hematoma along the left frontoparietotemporal convexity. After treatment of the subdural hematoma with craniotomy and evacuation, he developed remote cerebellar hemorrhage 1 week later.
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- Some patients have problems with their breathing during surgery because of a condition called obstructive sleep apnea.
- A new way to monitor breathing, called the Respiratory Effort Sequential Detection Algorithm (RESDA), uses information from breathing and jaw movement to help doctors find out if a patient's airway is blocked.
- The RESDA method was able to detect breathing blockages faster than older methods, but doctors still need to use other monitoring tools to keep patients safe.
A 50-year-old man with a history of chronic pancreatitis due to alcoholism presented with dyspnea, at which time he was diagnosed with pleural effusions, treated, and discharged. Two months later, he was readmitted with hemoptysis and abdominal pain. CT and MRI of the chest demonstrated a mediastinal cystic mass that communicated with the retroperitoneum.
View Article and Find Full Text PDFBackground: Chronic pain is no longer an effective warning system, but a syndrome with co-morbidities and many causes, needing a careful evaluation. Questions remain about the pain behaviour of chronic pain patients compared with patients with acute pain, or healthy subjects that we investigated.
Methods: We compared three populations: healthy (HS, n=280), with acute pain (AP=110 patients), and chronic pain (CP=280 patients) by assessing their pain behaviour with the pain sensitivity questionnaire (PSQ-total and PSQ-minor).
Study Design: This was a prospective study evaluating the Pain Sensitivity Questionnaire (PSQ) in 110 patients undergoing spine surgery.
Objective: The purpose of this study was to compare the ability of the PSQ-total and PSQ-minor scores with the Pain Catastrophizing Scale (PCS) in predicting the immediate postoperative pain of patients after spinal surgery and their risk of developing a chronically painful state.
Summary Of Background Data: Studies evaluating the PSQ as a preoperative determinant for the development of chronic pain are lacking.
Article Synopsis
- The study aimed to see if adding ketamine to pain relief during a medical procedure helps reduce breathing problems in patients.
- It involved 132 women, with most completing the study, where some received ketamine and others received a saline solution.
- Results showed that adding ketamine didn't significantly lower breathing problems but did lead to less pain and nausea for those who received it.
Objectives: The objective of this study was to describe the outcomes of patients in the University of Iowa Neuroendocrine Tumor (NET) Database treated with peptide receptor radionuclide therapy (PRRT).
Methods: One hundred thirty-five patients from the University of Iowa NET Database who received PRRT were analyzed, their characteristics were described, and survival was calculated.
Results: The median age at diagnosis was 51 years, and 64% were men.
A 61-year-old woman presented to the emergency department, with a 4-day history of isolated oropharyngeal dysphagia associated with anorexia and weight loss over the previous 4 weeks. She had no other focal neurological symptoms and no deficits on examination. She had been in a 4-year remission of breast cancer postmastectomy and chemoradiation.
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