Articles: cations.
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Randomized Controlled Trial
Driving Pressure during Thoracic Surgery: A Randomized Clinical Trial.
Driving pressure (plateau minus end-expiratory airway pressure) is a target in patients with acute respiratory distress syndrome, and is proposed as a target during general anesthesia for patients with normal lungs. It has not been reported for thoracic anesthesia where isolated, inflated lungs may be especially at risk. ⋯ Application of driving pressure-guided ventilation during one-lung ventilation was associated with a lower incidence of postoperative pulmonary complications compared with conventional protective ventilation in thoracic surgery.
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Randomized Controlled Trial Multicenter Study
Randomized clinical trial of selective decontamination of the digestive tract in elective colorectal cancer surgery (SELECT trial).
Infectious complications and anastomotic leakage affect approximately 30 per cent of patients after colorectal cancer surgery. The aim of this multicentre randomized trial was to investigate whether selective decontamination of the digestive tract (SDD) reduces these complications of elective colorectal cancer surgery. ⋯ SDD reduces infectious complications after colorectal cancer resection but did not significantly reduce anastomotic leakage in this trial. Registration number: NCT01740947 ( https://www.clinicaltrials.gov).
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Controversy is not uncommon in the diagnosis of discogenic low back pain (DLBP) and in the identification of the location of the pain source for the symptomatic disc in patients with DLBP. Various techniques, from minimally invasive procedures to fusion surgery, are used to treat chronic DLBP, but the clinical outcomes are variable. Percutaneous endoscopic discectomy by transforaminal or interlaminar approach is considered to be an effective method to treat DLBP, but the evidence is limited; the lack of clear evidence may be associated with patient selection and surgical technique. ⋯ Transforaminal, interlaminar, outside-in technique, endoscopic discectomy, discogenic low back pain.
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Observational Study
Uncinate Process Area as a New Sensitive Morphological Parameter to Predict Cervical Neural Foraminal Stenosis.
Hypertrophy of the uncovertebral joint has been considered as a major cause of cervical neural foraminal stenosis (CNFS). The cross-sectional area of the uncinate process is a key morphologic parameter in the identification of uncovertebral joint hypertrophy. To evaluate the connection between CNFS and the uncinate process, we devised a new morphological parameter, the uncinate process area (UPA). ⋯ The newly devised UPA is a sensitive parameter for assessing CNFS. A hypertrophied UPA is associated with an increased risk of CNFS. We think that this result will be helpful for diagnostic radiology in evaluating patients with CNFS.Institutional Review Board (IRB) approval number: IS16RISI0002KEY WORDS: Uncinate process area, cervical neural foraminal stenosis, Uncovertebral joint hypertrophy, optimal cut-off point, cross- sectional area.
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The methodology used during the development of American Society of Anesthesiologists evidence-based practice parameters, from conceptualization through final adoption of the documents, is described. Features of the methodology include the literature search, review and analysis, survey development and application, and consolidation of the full body of evidence used for preparing clinical practice recommendations. Anticipated risks of bias, validation of the process, and the importance of the documents for clinical use are discussed.