Peripartum Management of Gitelman Syndrome for Vaginal Delivery: A Case Report and Review of Literature.

We describe the anesthetic management of a spontaneous vaginal delivery at 38 weeks' gestation in a 36-year-old patient with Gitelman syndrome (GS). GS is a rare autosomal recessive renal tubulopathy characterized by hypomagnesemia, hypocalciuria, and secondary aldosteronism, which results in hypokalemia and metabolic alkalosis. To minimize any increase in catecholamine levels and consequent risk of ventricular arrhythmias, a labor epidural analgesia was administered using ropivacaine and fentanyl, along with intravenous magnesium and potassium supplementation.

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study.

Importance: Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning.

Objective: To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition.

Background: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development.

Pencil-point needle bevel direction influences ED50 of isobaric ropivacaine with fentanyl in spinal anesthesia for cesarean delivery: a prospective, double-blind sequential allocation study.

Background: There is little evidence on the influence of bevel direction of a pencil-point needle on the median effective dose (ED50) of isobaric ropivacaine and fentanyl in spinal anesthesia for cesarean delivery.

Methods: In this prospective, double-blind, sequential allocation study, 82 parturients scheduled for elective cesarean delivery under combined spinal-epidural anesthesia were included. We sought to determine the median effective dose of intrathecal 0.

Pleural fluid glucose: A predictor of unsuccessful pleurodesis in a preselected cohort of patients with malignant pleural effusion.

Purpose: To assess whether exclusion of patients with conditions that could lead to large fluctuations of serum glucose, would increase the accuracy of pleural fluid glucose in predicting pleurodesis outcome in patients with malignant pleural effusion subjected to bleomycin pleurodesis.

Methods: A retrospective analysis of 162 patients with recurrent, symptomatic malignant pleural disease was performed. Patients with diabetes mellitus or other causes of hyperglycemia were excluded, as pleural fluid glucose has been reported to be sensitive to serum glucose fluctuations.

Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration.

Methods: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART).

Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.

Methods: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013.

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success.

Methods: We generated updated estimates of child mortality in early neonatal (age 0-6 days), late neonatal (7-28 days), postneonatal (29-364 days), childhood (1-4 years), and under-5 (0-4 years) age groups for 188 countries from 1970 to 2013, with more than 29,000 survey, census, vital registration, and sample registration datapoints.

Comparison of blind intubation through the I-gel and ILMA Fastrach by nurses during cardiopulmonary resuscitation: a manikin study.

Objectives: To investigate whether nursing staff can successfully use the I-gel and the intubating laryngeal mask Fastrach (ILMA) during cardiopulmonary resuscitation.

Background: Although tracheal intubation is considered to be the optimal method for securing the airway during cardiopulmonary resuscitation, laryngoscopy requires a high level of skill.

Methods: Forty five nurses inserted the I-gel and the ILMA in a manikin, with continuous and without chest compressions.

Influence of LMA cuff pressure on the incidence of pharyngolaryngeal adverse effects and evaluation of the use of manometry during different ventilation modes: a randomized clinical trial.

Background: Pharyngolaryngeal discomfort is a significant complication following the use of laryngeal mask airway (LMA). The present study aimed to investigate the relation of LMA cuff pressure and the occurrence of pharyngolaryngeal discomfort during spontaneous ventilation (SV), pressure support (PSV) and pressure control ventilation (PCV).

Methods: A hundred and twenty patients, ASA I-III, were included in this study.

An intraoperative case of spontaneous restoration of circulation from asystole: a case of lazarus phenomenon.

This case report refers to a victim of intraoperative cardiac arrest, who restored spontaneous circulation despite of cessation of cardiopulmonary resuscitation (CPR). The victim, a 53-year-old man, was undergoing a surgical investigation and rehabilitation of a thigh hematoma. Two minutes after discontinuation of a 46 min CPR, a normotensive sinus node rhythm appeared at monitor.

First experience of the use of the C-MAC PM videolaryngoscope in a clinical setting by anesthetic nurses: a comparison with anesthetists.

Background: The Storz C-MAC videolaryngoscope has been found to facilitate endotracheal intubation and to be easy to use by novice users. However, it has never been studied in those who will probably use it most, anesthetists and anesthetic nurses. The aim of the present study was to identify the number of attempts needed before the participants were able to intubate 2 consecutive patients within 30 seconds.

An experimental model of neonatal normocapnic hypoxia and resuscitation in Landrace/Large White piglets.

Objective: The aim of this study is to describe and evaluate an experimental model of neonatal normocapnic hypoxia and resuscitation.

Methods: Ten male Landrace/Large White neonatal piglets were studied. Following anaesthesia and intubation, the animals were mechanically ventilated.

Continuous chest compressions improve survival and neurologic outcome in a swine model of prolonged ventricular fibrillation.

Introduction: Evidence suggests that any interruptions, including those of rescue breaths, during cardiopulmonary resuscitation (CPR) have significant, detrimental effects on survival. The 2010 International Liaison Committee on Resuscitation guidelines strongly emphasized on the importance of minimizing interruptions during chest compressions. However, those guidelines also stress the need for ventilations in the case of prolonged cardiac arrest (CA), and it is not at present clear at which point of CA the necessity of providing ventilations overcomes the hemodynamic compromise caused by chest compressions' interruption.

Quality of life and pre-operative anxiety level in patients scheduled to undergo thoracic surgery.

Purpose: Increased preoperative anxiety levels may lead to adverse outcomes. We aimed at assessing the relationship between quality of life (QoL) and preoperative anxiety level during the 4-week preoperative period in patients scheduled to undergo thoracic surgery and we tried to identify patients who could benefit from preoperative supportive measures.

Methods: One hundred patients comprised the study population (52 men and 48 women) out of the initial 136, who were scheduled to undergo thoracic surgery.

Inexperienced nurses and doctors are equally efficient in managing the airway in a manikin model.

Objective: The aim of the present study was to investigate whether minimally trained medical and nursing school graduates would be equally efficient in placing a laryngeal mask airway (LMA) and in intubating the trachea with the Macintosh blade or a videolaryngoscope in a manikin model. Airway management is an essential skill for both physicians and nurses who may be confronted with a critically ill patient, because in the emergency department the airway is not exclusively managed by medical personnel. Several studies have shown that other healthcare professionals are not any less efficient in securing the airway.

A comparison of the i-gel and classic LMA insertion in manikins by experienced and novice physicians.

Objective: Airway management is of utmost importance in critical patients, for whom endotracheal intubation remains the gold standard. However, it is a difficult skill to acquire and success rates in novices are unacceptably low. Supraglottic devices constitute promising alternatives.

A model of hemorrhagic shock and acute lung injury in Landrace-Large White Swine.

Traumatic injury is a leading cause of death worldwide for people between 5 and 44 y of age, and it accounts for 10% of all deaths. The incidence of acute lung injury, a life-threatening complication in severely injured trauma patients remains between 30% and 50%. This study describes an experimental protocol of volume-controlled hemorrhage in Landrace-Large White swine.