Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity最新文献

{"title":"#36161 Regional anesthesia as part of a multimodal blood conservation strategy in a Jehovah’s witness","authors":"Rita Barbosa, Glória Simas Ribeiro, João Valente Jorge, Lucindo Ormonde","doi":"10.1136/rapm-2023-esra.424","DOIUrl":"https://doi.org/10.1136/rapm-2023-esra.424","url":null,"abstract":"<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant (see information at the bottom of this page) <h3>Background and Aims</h3> Preoperative optimization of anemia is particularly important in Jehovah’s Witnesses before major surgery. However, when presenting in an acute setting there are no recommendations, and a multimodal and multidisciplinary approach is necessary to safely deliver treatment. Regional anesthesia has a particular role in reducing complications. <h3>Methods</h3> Case report. <h3>Results</h3> A 74-year-old male was admitted in our institution for above-knee amputation of the left lower extremity due to irreversible ischemia. His past medical history was relevant for multiple myeloma, hypertension and type 2 diabetes mellitus. His baseline hemoglobin was 7.7 g/dL. He was a Jehovah’s Witness who refused blood transfusions, having been transferred from another institution, where he was denied surgery. Two days before surgery, ferric carboxymaltose 500 mg was administered. Surgery was performed under combined spinal-epidural anesthesia, with 7 mg of intrathecal hyperbaric bupivacaine. Before the beginning of surgery, tranexamic acid 1 g was administered. Hemodynamic stability was achieved, with minimal blood loss (200 mL). The final hemoglobin was 6.4 g/dL. For postoperative analgesia a multimodal approach was implemented, with patient-controlled epidural analgesia with ropivacaine 0.2%. After surgery, darbepoetin alfa 500 micrograms was administered. He was transferred back to his original institution after two days. <h3>Conclusions</h3> Lower extremity amputation carries a significant risk of perioperative morbidity and mortality. Regional anesthesia may confer several advantages over general anesthesia, having demonstrated a reduction of blood transfusion requirements in the setting of lower extremity amputation. Therefore, it should be considered as part of a blood conservation strategy. <h3>Attachment</h3> Patient Consent for Publication.pdf","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"253 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135686121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#35945 Cervical subcutaneous emphysema and pneumomediastinum secondary to penetrating trauma","authors":"Carlota Gordaliza, Silvia de Miguel Manso, Rocío Gutiérrez Bustillo, Belén Sánchez Quirós, Rocío López Herrero","doi":"10.1136/rapm-2023-esra.440","DOIUrl":"https://doi.org/10.1136/rapm-2023-esra.440","url":null,"abstract":"<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant (see information at the bottom of this page) <b>Application for ESRA Abstract Prizes:</b> I don’t wish to apply for the ESRA Prizes <h3>Background and Aims</h3> Subcutaneous emphysema (SE) is a finding of gas within the subcutaneous soft tissues, usually in the chest or neck. There are numerous causes for this phenomenon, including blunt and penetrating trauma, soft tissue infection, and surgical instrumentation. <h3>Methods</h3> We present the case of a 39-year-old man with cervical SE and pneumomediastinum after penetrating cervical trauma due to attempted suicide. A cervical-thoracic CT showed the presence of pneumomediastinum and significant cervical subcutaneous emphysema. As a preventive measure, the patient was admitted to the Resuscitation Unit to ensure the airway through orotracheal intubation. He was kept under sedation for 48 hours and broad-spectrum empirical antibiotic therapy was prescribed. After this time, the CT was repeated and, given the marked decrease in emphysema, the patient was extubated without incident. <h3>Results</h3> SE occurs when air becomes trapped under the skin. Air forced into the interstitial tissues around the pulmonary vasculature travels back toward the hilum, leading to pneumomediastinum, and this eventually spreads to the soft tissues of the neck, face, and chest wall. In our patient, penetrating trauma was the event that caused the entry of air into the tissues. In most cases, it does not involve airway compromise as subcutaneous air easily accommodates the distensible subcutaneous tissues and conservative treatment is adequate. Subcutaneous drainage or supraclavicular incisions are safe techniques with no reported complications (2). <h3>Conclusions</h3> SE is usually not necessarily dangerous, and conservative treatment is usually sufficient. However, on occasions like the case presented here, it can compromise the airway and require invasive therapeutic measures.","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135686122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#33829 Association between the time of surgery and the incidence of postoperative nausea – vomiting: propensity score matched analysis","authors":"Shariq Ali Khan, Zaw Ahar Kar, Gek Hsiang Lim","doi":"10.1136/rapm-2023-esra.435","DOIUrl":"https://doi.org/10.1136/rapm-2023-esra.435","url":null,"abstract":"<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant (see information at the bottom of this page) <b>Application for ESRA Abstract Prizes:</b> I don’t wish to apply for the ESRA Prizes <h3>Background and Aims</h3> A study by Wright et al found that the probability of postoperative nausea and vomiting (PONV) increased for cases starting at 2pm compared with 7am. There has been no other study published exploring the association between time of surgery and PONV. To address this gap in knowledge, we conducted a study to determine the effect of surgical time of day on PONV. <h3>Methods</h3> With ethics approval, data of all patients undergoing elective non-cardiac non-neurosurgery , having a high-risk of PONV and which had a 24-hour assessment of PONV between October 2017 to December 2020 were extracted. Surgical-sessions were classified as either Morning-surgery (defined as start-time and end-time before noon) or Afternoon-surgery (defined as surgery start-time at 12noon) . Those patients which had surgical-sessions extending across morning-sessions to afternoon-sessions were excluded. A propensity-score-matching (PSM) based on 1:1 matching was performed to potential biases. For the entire study population before matching, we used Pearson’s chi-square test or Fisher’s exact-test for categorical- variables; and Student’s t-test or Mann-Whitney U-test for normally or non-normally distributed continuous-variables, respectively. For the matched study-population, we used conditional logistic-regression to test for differences. A p-value of <0.05 was considered statistically significant. <h3>Results</h3> Of the 3808 surgical-sessions,1439 surgical-sessions were excluded from analysis because they extended between morning and afternoon-surgery. After 1:1 PSM, 1043 matched-pairs were obtained (table 1). The incidence of PONV, prior to matching remained statistically insignificant even after PSM (table 2). <h3>Conclusions</h3> We found that the time of surgery did not affect both the overall incidence and severity of PONV. <h3>Attachment</h3> tables.docx","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135686278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#35884 Comparison of ultrasound tissue simulator and Needle Trainer in a simulated training environment among novice anaesthesiology trainees in regional anaesthesia","authors":"Weng Ken Chan, Kok Wang Tan, Iskandar Khalid, Afifah Samsudin, Asmah Azizeh, Vimal Varma Spor Madiman, Azarinah Izaham, Mohammad Nizam Mokhtar","doi":"10.1136/rapm-2023-esra.395","DOIUrl":"https://doi.org/10.1136/rapm-2023-esra.395","url":null,"abstract":"<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission <b>Application for ESRA Abstract Prizes:</b> I don’t wish to apply for the ESRA Prizes <h3>Background and Aims</h3> Utilising ultrasound technology has resulted in higher success and lower complication rates during regional anaesthesia (RA) procedures. Proper training is necessary to accurately identify structures, optimise images, and improve hand-eye coordination. Simulation training using immersive virtual environments and simulation models has enabled this competency training to be conducted safely before performing on patients. We conducted a study to compare the simulator performance and users’ feedback on a Blue Phantom Regional Anaesthesia Ultrasound Training Block (BP) and NeedleTrainer (NT). <h3>Methods</h3> Forty-seven participants (anaesthesiology and non-anaesthesiology practitioners) were recruited via convenient sampling during a RA workshop for novice practitioners. They were divided into the NT or BP group and then crossover to experience both NT and BP. Time-to-reach-target, first-pass success rate, and complication rate were assessed, while the learning and confidence scores were rated using six-item and three-item questionnaires, respectively, via a 5-point Likert scale. <h3>Results</h3> BP group has a longer time-to-target as compared to the NT group (20±20 vs 10±9 sec, p=0.002), higher first-pass success rate (100% vs 80.9%), and lower complication rate (0% vs 19.1%). Higher learning satisfaction scores (26.7±3.1 vs 24.7±4.5, p=0.002) and confidence scores after training (13.1±1.9 vs 11.9±2.3, p<0.001) were recorded among the BP group. Further analysis is shown in table 1. <h3>Conclusions</h3> We postulated that the artificial intelligence structure recognition software enables NT users to attain shorter time-to-target. In conclusion, BP provides better operator learning satisfaction, improved confidence, higher success and lower complication rates among novice RA practitioners, possibly due to greater tactile feedback during the simulated training. <h3>Attachment</h3> Ethics approval.pdf","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135687511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#36076 Investigating the most difficult concepts in anaesthesia for medical students","authors":"Wan Xi Ho, Zi Xian Justin Chou, Haowen Jiang, Joselo Macachor","doi":"10.1136/rapm-2023-esra.399","DOIUrl":"https://doi.org/10.1136/rapm-2023-esra.399","url":null,"abstract":"<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant (see information at the bottom of this page) <h3>Background and Aims</h3> In clinical postings, time for teaching is limited. To maximize effectiveness, educators should prioritize teaching topics that students struggle to learn independently. We surveyed medical students to identify these topics and better inform lesson planning. <h3>Methods</h3> We derived the anaesthesiology curriculum from the textbook ‘Anesthesiology Student Survival Guide’. With input from an anaesthetist educator and a pilot survey, we identified the 5 most important and challenging concepts from major topics including Pharmacology &amp; Physiology, Intensive Care, Peri-operative Care, and Traditional Anaesthesia. We then asked clinical year medical students at the Lee Kong Chian School of Medicine, Singapore to rate the concepts (1 to 5, 5 indicating extreme difficulty). We also surveyed why they found these concepts challenging and how they overcame the difficulties. <h3>Results</h3> We received 139 out of a maximum of 394 responses (35.3% response rate), yielding a margin of error of ±6.70% at the 95% confidence interval. The hardest concepts are as follows (with scoring): Pharmacology &amp; Physiology: Pharmacokinetics of anticoagulants (3.25/5), context sensitive half- life (3.56/5) Intensive Care: Approach to hypo/hyperthermia (3.34/5) Peri-operative Care: Capnograph interpretation (3.06/5), minimum alveolar concentration (MAC) (3.47/5) Traditional Anaesthesia: Neuromuscular blocking agents (3.12/5), nerve block anatomy (3.56/5) For intensive care, lack of practice was the main challenge, while for the other topics, it was difficulty understanding the concepts. The most effective learning method for all topics was a teaching by someone else. <h3>Conclusions</h3> Our study identifies key anaesthesiology topics and effective teaching strategies for educators, helping to optimize limited clinical posting time and improve student understanding.","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135687545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2022-RA-1511-ESGO Endometrial stromal sarcomas – a 12 year single centre experience","authors":"D. Giannoulopoulos, S. Lekka, K. Kokkali, D. Korfias, Eugenia Karavioti, C. Iavazzo, G. Vorgias","doi":"10.1136/ijgc-2022-esgo.457","DOIUrl":"https://doi.org/10.1136/ijgc-2022-esgo.457","url":null,"abstract":"","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90155155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2022-RA-1199-ESGO 5 times ovarian pedicle torsion due to pedunculated paratubal cyst in 15 years old girl","authors":"Huda Abdelrhman Osman Ahmed, Sameer Sendy","doi":"10.1136/ijgc-2022-esgo.439","DOIUrl":"https://doi.org/10.1136/ijgc-2022-esgo.439","url":null,"abstract":"event. Abstract 2022-RA-1153-ESGO Table 1 Conclusion Intensive perioperative thromboprophylaxis with tinzaparin 8.000 Anti-Xa IU, OD for up to 1 month post gynecologic cancer surgery found to be effective and safe. Additional data is needed to confirm these findings.","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83094422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2022-RA-597-ESGO Neuroendocrine carcinoma of the breast: a case report","authors":"Asma Selmane, S. Tbessi, F. Bouguerra, Amal Chamsi, R. Melliti, S. Belajouza, N. Bouzid, S. Tebra","doi":"10.1136/ijgc-2022-esgo.400","DOIUrl":"https://doi.org/10.1136/ijgc-2022-esgo.400","url":null,"abstract":"","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79656930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2022-RA-1684-ESGO Primary neuroendocrine tumors of the breast: a series of five cases","authors":"A. Jellali, S. Sakhri, Takoua Chalouati, M. Bouhani, Sarra Ben Ltaief, R. Chargui, K. Rahal","doi":"10.1136/ijgc-2022-esgo.473","DOIUrl":"https://doi.org/10.1136/ijgc-2022-esgo.473","url":null,"abstract":"","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80574207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2022-RA-1686-ESGO Pure ductal carcinoma in situ in the male breast: an uncommon entity","authors":"A. Jellali, S. Sakhri, Takoua Chalouati, M. Bouhani, Sarra Ben Ltaief, O. Jaidane, K. Rahal","doi":"10.1136/ijgc-2022-esgo.474","DOIUrl":"https://doi.org/10.1136/ijgc-2022-esgo.474","url":null,"abstract":"are no specific treatment guidelines, and the available data is primarily based on case reports","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86591925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}