A unique 5-year program designed to improve the quality and availability of anesthesia care in developing nations has been initiated in East Africa. Based upon North American anesthesiologists serving as volunteer teachers, the program emphasizes teaching to the exclusion of taking over anesthesia care. The teaching is practical and relevant to the clinical practice of anesthesia in developing countries. The volunteers teachers serve, one at a time, 12 months of the year for several years in two pre-existing structured East African anesthesia training programs, thereby providing the advantages of consistent, reliable teaching assistance for a period of years to programs of demonstrable interest and experience in anesthesia training.
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Cureus
December 2024
Anesthesia and Critical Care, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR.
Background Diabetic ketoacidosis (DKA) is one of the leading causes of morbidity and mortality in children with diabetes, often requiring intensive care unit management. This study aimed to identify factors associated with the severity of DKA in infants and children hospitalized in pediatric intensive care. Methodology This retrospective, monocentric, descriptive, analytical study included infants and children aged one month to 17 years who presented with DKA meeting the International Society for Pediatric and Adolescent Diabetes 2022 criteria.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
January 2025
Department of Cardiac Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Acute coronary occlusion during transcatheter aortic valve implantation (TAVI) is an unwarranted complication associated with high mortality. The current TAVI practices recommend a multidetector computed tomography (MDCT) evaluation of the aortic valve, the left ventricular outflow tract, and the aortic root to determine the conventional risk factors for coronary obstruction like low-lying coronary ostia and narrow sinuses of Valsalva, mandating prophylactic coronary protection or native valve leaflet modification in high-risk patients. Despite optimal anatomy, acute coronary occlusion can still occur due to multiple mechanisms, one of which is coronary embolism due to thrombus, calcium, or native aortic valve fragments.
View Article and Find Full Text PDFJMIR Med Educ
January 2025
Department of Anesthesia Critical Care Medicine, Keck School of Medicine, University of South California, Los Angeles, CA, United States, United States.
Intro: Extracorporeal membrane oxygenation (ECMO) is a critical tool in the care of severe cardiorespiratory dysfunction. Simulation training for ECMO has become standard practice. Therefore, Keck Medicine of the University of California (USC) holds simulation-training sessions to reinforce and improve providers knowledge.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94612, USA.
Background: Clinical determination of patients at high risk of poor surgical outcomes is complex and may be supported by clinical tools to summarize the patient's own personalized electronic health record (EHR) history and vitals data through predictive risk models. Since prior models were not readily available for EHR-integration, our objective was to develop and validate a risk stratification tool, named the Assessment of Geriatric Emergency Surgery (AGES) score, predicting risk of 30-day major postoperative complications in geriatric patients under consideration for urgent and emergency surgery using pre-surgical existing electronic health record (EHR) data.
Methods: Patients 65-years and older undergoing urgent or emergency non-cardiac surgery within 21 hospitals 2017-2021 were used to develop the model (randomly split: 80% training, 20% test).
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Although cardiovascular anesthesiologists play a role in the multidisciplinary heart team, they are generally not involved prior to the diagnosis of coronary artery disease. This work was designed to broadly cover the factors influencing decision-making when proceeding with coronary angiography in a patient with suspected coronary artery disease. The authors cover the principles, rationale, benefits, and downsides of common tests involved.
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