External and Implantable Pacemakers and Defibrillators

2019 ◽  
Author(s):  
Roya Saffary
Keyword(s):  
Elective Surgery ◽  
Perioperative Period ◽  
The United States ◽  
Surgical Instruments ◽  
Future Directions ◽  
Cardiac Devices ◽  
History Of ◽  
Implantable Cardiac Devices ◽  
Monopolar Electrocautery ◽  
Implantable Pacemaker

Approximately 250,000 pacemakers are implanted every year in the United States.26 As the population continues to age, the number is likely to increase; therefore, it is imperative for all physicians, especially anesthesiologists, to become familiar with implantable cardiac devices and the appropriate management of patients with these devices. Anesthesiologists must be comfortable evaluating and managing patients with pacemakers and/or defibrillators during the perioperative period, as more of this patient population present for noncardiac, elective surgery. This requires a strong understanding of the types of devices, indications, settings, and functionality. In addition, it is important to understand and anticipate possible interactions during surgery with surgical instruments, such as bi- and monopolar electrocautery. This review provides a brief overview of the history of implantable devices, presents the guidelines regarding indications for placement, discusses important management considerations, and concludes with recent advances and future directions. This review contains 1 figures, 5 tables, and 30 references.  Key Words: cardiac, defibrillator, electrophysiology, external, implantable, pacemaker, pacing, transcutaneous, transvenous

Acute Severe Asthma and Bronchospasm

2017 ◽  
Author(s):  
Amanda T. Redding ◽  
Marc Hassid
Keyword(s):  
Airway Hyperresponsiveness ◽  
Acute Asthma ◽  
Treatment Algorithm ◽  
Perioperative Period ◽  
The United States ◽  
Airway Hyperreactivity ◽  
First Line ◽  
The People ◽  
Reversible Airway Obstruction ◽  
History Of

This chapter focuses on acute asthma and bronchospasm occurring in the perioperative period. Over 6% of the people in the United States have asthma, which is characterized by chronic inflammation, airway hyperresponsiveness, excessive mucus, and reversible airway obstruction. Due to generalized airway hyperreactivity, a history of asthma increases the risk of coughing, wheezing, bronchospasm, and oxygen desaturation. Although the incidence of bronchospasm associated with asthma is low, when it occurs it is often severe. A stepwise treatment algorithm is defined, which covers the use of first line agents such as inhaled beta-2 agonists and steroids, but also agents that are useful for refractory cases such as epinephrine, magnesium, and possibly ketamine.

scholarly journals The Impact of COVID-19 on Epilepsy Care: A Survey of the American Epilepsy Society Membership

2020 ◽  
Vol 20 (5) ◽  
pp. 316-324
Author(s):  
Dara V. F. Albert ◽  
Rohit R. Das ◽  
Jayant N. Acharya ◽  
Jong Woo Lee ◽  
John R. Pollard ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Clinical Care ◽  
Single Point ◽  
The United States ◽  
Prior History ◽  
Delivery Of Care ◽  
History Of ◽  
Almost All ◽  
The Impact ◽  
New Onset

The COVID-19 pandemic has impacted the delivery of care to people with epilepsy (PWE) in multiple ways including limitations on in-person contact and restrictions on neurophysiological procedures. To better study the effect of the pandemic on PWE, members of the American Epilepsy Society were surveyed between April 30 and June 14, 2020. There were 366 initial responses (9% response rate) and 337 respondents remained for analysis after screening out noncompleters and those not directly involved with clinical care; the majority were physicians from the United States. About a third (30%) of respondents stated that they had patients with COVID-19 and reported no significant change in seizure frequency. Conversely, one-third of respondents reported new onset seizures in patients with COVID-19 who had no prior history of seizures. The majority of respondents felt that there were at least some barriers for PWE in receiving appropriate clinical care, neurophysiologic procedures, and elective surgery. Medication shortages were noted by approximately 30% of respondents, with no clear pattern in types of medication involved. Telehealth was overwhelmingly found to have value. Among the limitation of the survey was that it was administered at a single point in time in a rapidly changing pandemic. The survey showed that almost all respondents were affected by the pandemic in a variety of ways.

History of Neuropsychology in Latin America

2019 ◽  
Author(s):  
Juan Carlos Arango Lasprilla ◽  
Laiene Olabarrieta-Landa ◽  
Isabel Gonzalez ◽  
Giselle Leal ◽  
José Enrique Álvarez Alcántara ◽  
...  
Keyword(s):  
Latin America ◽  
Latin American ◽  
The United States ◽  
Second World War ◽  
Armed Conflicts ◽  
Future Directions ◽  
Current State ◽  
History Of ◽  
Main Activity ◽  
Second World

This chapter presents the history of neuropsychology in Latin America during five main periods. Prior to 1950, the term “neuropsychology” was rarely used. The development of this specialty in Latin America did not take place until the second half of the 20th century, centered primarily in Argentina and Uruguay. Historically, the development of neuropsychology has been slowed down by local wars, armed conflicts, and dictatorships. During the Second World War, intellectuals and scientists in neuroscience emigrated to Latin America and helped to advance the field. The period between 1970 and 1999 was mainly characterized by the evolution of neuropsychology in Colombia and Mexico and by the influence of the United States in Latin American neuropsychology. From 2000 until 2017, neuropsychology experienced a rapid growth, including establishment of graduate programs, societies, clinics/centers, Latin American scientific journals, and research publications, as well as the creation of Spanish language neuropsychological tests. As of 2018, most professionals in neuropsychology in Latin America work in private practices or universities, and their main activity is assessment and diagnosis of neurodevelopmental and neurodegenerative disorders, although they also engage in rehabilitation and teaching activities. Due to the lack of written records, there is scarce information regarding the history and current state of neuropsychology in some Latin American countries, including Belize, Haiti, and the Dominican Republic. Current barriers to the advancement of the field and future directions to improve the current situation are described.

Abolitionist futures and the US sanctuary movement

Race & Class ◽  
2017 ◽  
Vol 59 (2) ◽  
pp. 3-25 ◽  
Author(s):  
A. Naomi Paik
Keyword(s):  
United States ◽  
The United States ◽  
Donald Trump ◽  
Future Directions ◽  
The Us ◽  
History Of ◽  
Main Components ◽  
Prison Abolition ◽  
Abolition Movement

This article focuses on the histories, current challenges, and future directions of the sanctuary movement in the United States, which is becoming a central front of resistance to the administration of Donald Trump. The article is comprised of three main components. It discusses the history of the US sanctuary movement and situates it in the context of the rise of neoliberalism and its attendant escalating criminalisation, particularly since the 1980s, when the first iteration of the movement began. The article then discusses the limits of sanctuary, rooted in the movement’s liberal framework that risks reproducing the exclusions it has sought to dismantle. It nevertheless argues for the importance of sanctuary in opposing the Trump regime, while advocating that the movement adopt a more radical framework and solidarity-organising strategies inspired by the prison abolition movement.

Abstract 15038: Gender Differences Amongst Caucasians and African Americans in Rates of Arrhythmias, Implantable Cardiac Devices, and In-hospital Mortality in Sarcoidosis Patients With Cardiomyopathy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Chaitanya Rojulpote ◽  
Karthik Gonuguntla ◽  
Shivaraj Patil ◽  
Pranav Karambelkar ◽  
Tapan Buch ◽  
...  
Keyword(s):  
Gender Differences ◽  
Coronary Artery ◽  
Catheter Ablation ◽  
Hospital Mortality ◽  
Bypass Graft ◽  
Muscle Disease ◽  
Cardiac Resynchronization ◽  
Cardiac Devices ◽  
History Of ◽  
Implantable Cardiac Devices

Introduction: The prevalence of sarcoid cardiomyopathy (SCM) with female predominance is well known. However, gender differences amongst individual races remains poorly studied. Hypothesis: We sought to determine and compare within each gender and race, the rates of arrhythmias, implantable cardiac devices, and in-hospital mortality in patients with SCM after excluding those with a history of coronary artery disease. Methods: The Nationwide Inpatient Sample was queried from 2010 to 2014 using ICD-9 diagnosis code (135) for sarcoidosis among patients >18 years old. We combined it with code (425.8) for cardiomyopathy in other diseases including sarcoid and sarcoid heart muscle disease. We excluded patients with a history of prior myocardial infarction, percutaneous coronary intervention and coronary artery bypass graft. Results: From 2010 to 2014, we identified 9,063 patients with SCM (mean age = 53.11 ± 11.28 years; men 51.8% and black 52.5%). Upon comparison of gender within races, event rates per 100 patients were (white male, white female, black male, black female; p-value): atrial fibrillation (20.7, 18.8, 18, 16.1; p=0.172), ventricular fibrillation (VF) (4.1, 1.7, 2.3, 2.1; p<0.001), ventricular tachycardia (VT) (33.1, 19.3, 25.1, 21; p<0.001), complete heart block (CHB) (9.1, 8.6, 3.4, 3.6; p=0.58), second degree Mobitz type II (0.3, 0.35, 0.8, 0.4; p=0.717), implantable cardioverter-defibrillator (ICD) (13.3, 9.3, 8.4, 9.2; p<0.001), cardiac resynchronization therapy defibrillator (CRT-D) (5.5, 1.4, 3.4, 2.5; p<0.001), permanent pacemaker (PPM) (2.2, 4.1, 1.1, 1.6; p<0.001), sudden cardiac arrest (SCA) (1.3, 1.7, 1.3, 2.4; p=0.34), endomyocardial biopsy (EMB) (3.6, 2.1, 1.9, 2.3; p=0.011), cardiac MRI (CMR) (1.4, 0.3, 0.7, 1.3; p=0.002), cardiogenic shock (2.5, 1.4, 3, 3; p=0.027), orthotopic heart transplantation (OHT) (2.3, 1.4, 1.1, 0.2; p=0.05), catheter ablation (8.3, 4.5, 3.8, 1.9; p<0.001), and in-hospital mortality (1.7, 3, 2.9, 2.6; p=0.008). Conclusion: White males had higher rates of VF, VT, CHB, but they also had a lower in-hospital mortality and SCA rates likely due to higher procedural rates such as EMB, ICD, CRT-D, catheter ablation and OHT as compared to others.

The History of Surgical Staplers: A Combination of Hungarian, Russian, and American Innovation

2019 ◽  
Vol 85 (6) ◽  
pp. 563-566
Author(s):  
Alicia D. Gaidry ◽  
Laurier Tremblay ◽  
Don Nakayama ◽  
Romeo C. Ignacio
Keyword(s):  
United States ◽  
The United States ◽  
Surgical Instruments ◽  
Linear Stapler ◽  
Surgical Staplers ◽  
Original Design ◽  
Surgical Stapler ◽  
Tyco Healthcare ◽  
History Of ◽  
The 1960S

Since their development in 1908, surgical staplers have been used as a method of “mechanical suturing” in efforts to divide hollow viscera and create anastomoses in an efficient and sterile manner. The concept for the surgical stapler was first developed by Humér Hultl, a Hungarian professor and surgeon, and designed by Victor Fischer, a Hungarian businessman and designer of surgical instruments. The design was highly acclaimed; however, it was bulky, cumbersome, and expensive to manufacture. In 1920, Aladár Petz, a student of Hultl, incorporated two innovations to the Fischer-Hultl stapler to create a more lightweight model, which was named the Petz clamp. In 1934, Friedrich of Ulm designed what would be the predecessor to the modern-day linear stapler. In the 1950s, Russian and American staplers began to emerge. Throughout the 1960s, a variety of stapling instruments were developed in the United States, manufactured by the United States Surgical Corporation. In the 1970s, Johnson & Johnson Ethicon brand joined the market. The United States Surgical Corporation was later bought by Tyco Healthcare and became Covidien in 2007. Through the collaboration of Felicien Steichen, Mark Ravitch, and Leon Hirsch, surgical staplers were further modified to incorporate interchangeable cartridges with various designs. With the advent of minimally invasive surgery began production of laparoscopic surgical staplers. Since its inception, the surgical stapler has provided a means to efficiently create safe and effective visceral and vascular anastomoses. The surgical stapler design continues to evolve while still maintaining the basic principles that were implemented in the original design.

scholarly journals A History of the Children’s Evaluation and Rehabilitation Center (CERC) at the Albert Einstein College of Medicine, 1956-2008

2016 ◽  
Vol 25 (1) ◽  
pp. 25
Author(s):  
Herbert J Cohen
Keyword(s):  
Albert Einstein College ◽  
Albert Einstein ◽  
The United States ◽  
Developmentally Disabled ◽  
Faculty Members ◽  
Rehabilitation Center ◽  
Future Directions ◽  
The Past ◽  
Clinical Program ◽  
History Of

The Children’s Evaluation and Rehabilitation Center (CERC) is the oldest continuously Einstein-operated clinical program. Its history has paralleled that of other achievements at Einstein, as well as changes in the service system, legislative mandates, and creation of programs for the developmentally disabled in both the Bronx and the United States. This article describes the growth and development of CERC, identifies several key faculty members and staff who have been major contributors to CERC’s operations and to related Einstein activities, describes its numerous accomplishments over the past 50 years, and indicates some of the future directions for its programs. 

Acute Stroke

2017 ◽  
Author(s):  
Laurel E. Moore
Keyword(s):  
Neurological Disorders ◽  
Postoperative Morbidity ◽  
Elective Surgery ◽  
The United States ◽  
Noncardiac Surgery ◽  
Perioperative Stroke ◽  
Systemic Thrombolysis ◽  
Central Focus ◽  
Improved Outcomes ◽  
History Of

Stroke is the leading cause of disability in the United States, and in terms of mortality is second only to ischemic heart disease worldwide. Medical management for acute ischemic stroke (AIS) was limited to supportive care until 1995, when the National Institute of Neurological Disorders and Stroke (NINDS) trial demonstrated improved outcomes with systemic thrombolysis for AIS. Since December 2014, four major articles have been published in support of endovascular intervention for AIS, making this a central focus of this chapter. Other related topics for this chapter include the timing of elective surgery following stroke, how to assess perioperative risk for patients having a history of remote stroke, and implications for postoperative morbidity and mortality associated with perioperative stroke in noncardiac surgery.

scholarly journals Audit Studies of Housing in the United States: Established, Emerging, and Future Research

2021 ◽  
Author(s):  
S. Michael Gaddis ◽  
Nicholas V. DiRago
Keyword(s):  
Additional Data ◽  
Exchange Process ◽  
The United States ◽  
Future Research ◽  
Social Scientists ◽  
Future Directions ◽  
Housing Discrimination ◽  
Home Sales ◽  
History Of ◽  
The 1960S

Since the 1960s, social scientists, fair housing agencies, and the federal government have conducted hundreds of in-person and correspondence housing audits. Researchers use these covert experiments to make strong causal claims about difficult-to-detect behavior, such as racial, gender, and other types of discrimination. These studies have consistently uncovered discrimination in multiple stages and contexts of the housing exchange process. The housing audit literature is broad and robust, and a number of in-depth reviews already exist. In this chapter, we build on those reviews by focusing attention on emerging areas of inquiry and suggest new avenues of research pursuits. We begin by briefly reviewing the long history of housing audits including in-person HUD audits and correspondence audits of home sales and housing rentals. Next, we discuss three emerging areas of housing audit research – housing choice vouchers, short-term rentals, and roommate searches – and highlight important findings, new innovations, and areas of weakness. Finally, we conclude with a discussion about future directions of housing audits including using experiments to test for ways to reduce discrimination, using additional data to examine the mechanisms of housing discrimination, and designing modified audits to explore discrimination in other stages of housing exchange.

Special Considerations for Evaluation and Treatment of Spanish-Speaking Patients with Cleft Palate

2016 ◽  
Vol 1 (5) ◽  
pp. 41-49
Author(s):  
Ellen Moore
Keyword(s):  
Cleft Palate ◽  
The United States ◽  
Culturally Competent ◽  
Speech Language Pathology ◽  
Spanish Speaking ◽  
Appropriate Treatment ◽  
Oral Pressure ◽  
Language Pathology ◽  
History Of ◽  
Spanish Speaking Population

As the Spanish-speaking population in the United States continues to grow, there is increasing need for culturally competent and linguistically appropriate treatment across the field of speech-language pathology. This paper reviews information relevant to the evaluation and treatment of Spanish-speaking and Spanish-English bilingual children with a history of cleft palate. The phonetics and phonology of Spanish are reviewed and contrasted with English, with a focus on oral pressure consonants. Cultural factors and bilingualism are discussed briefly. Finally, practical strategies for evaluation and treatment are presented. Information is presented for monolingual and bilingual speech-language pathologists, both in the community and on cleft palate teams.

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