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1. Peripheral Artery Disease Causes More Harm to Patients than COVID-19.

Author

Kasiri, Mohammad Mahdi, Mittlboek, Martina, Giurgea, Giurgiana-Aura, Fortner, Norbert, Lirk, Philip, Eilenberg, Wolf, Gollackner, Bernd, and Neumayer, Christoph

Subjects
COVID-19, PERIPHERAL vascular diseases, RETROSPECTIVE studies, COMPARATIVE studies, LONGITUDINAL method
Abstract

Background: To optimize our strategic planning, we aimed to investigate the impact of the COVID-19 pandemic on the treatment of patients with peripheral artery disease (PAD) at our tertiary care hospital. Methods: We performed a retrospective single-center cohort study. In total, 1210 patients were included: 611 patients admitted between March and December 2020, compared to retrospective data from 599 patients from the same period in 2019. Results: Emergency admissions involving patients with advanced stage PAD increased significantly during the pandemic period of 2020, compared to the same period in 2019 (p < 0.0098). This increase was accompanied by increased limb amputations performed during the first lockdown, post-lockdown and the second lockdown in 2020, compared to respective time periods in 2019 (p < 0.0003, p < 0.0004, p = 1). No SARS-CoV-2 infection was observed among patients with PAD during the observation period. Conclusions: Strict lockdown protocols adversely affected the care of PAD patients, with persisting aftereffects, including increased emergency admission with unsuccessful revascularization attempts leading to limb amputation, even after the peak of the pandemic had passed. We believe that providing continuous care to PAD patients, even in times of global pandemics, will prevent the unfavorable outcomes observed during the COVID-19 pandemic in 2020. [ABSTRACT FROM AUTHOR]

Published
2022
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3. Risk of Epidural Hematoma after Neuraxial Techniques in Thrombocytopenic Parturients : A Report from the Multicenter Perioperative Outcomes Group

Author

Lee, Linden O., Bateman, Brian T., Kheterpal, Sachin, Klumpner, Thomas T., Housey, Michelle, Aziz, Michael F., Hand, Karen W., MacEachern, Mark, Goodier, Christopher G., Bernstein, Jeffrey, Bauer, Melissa E., Lirk, Philip, Wilczak, Janet, Soto, Roy, Tom, Simon, Cuff, Germaine, Biggs, Daniel A., Coffman, Traci, Saager, Leif, Levy, Warren J., Godbold, Michael, Pace, Nathan L., Wethington, Kevin L., Paganelli, William C., Durieux, Marcel E., Domino, Karen B., Nair, Bala, Ehrenfeld, Jesse M., Wanderer, Jonathan P., Schonberger, Robert B., Berris, Joshua, Lins, Steven, Coles, Peter, Cummings, Kenneth C., Maheshwari, Kamal, Berman, Mitchell F., Wedeven, Christopher, LaGorio, John, Fleishut, Peter M., Ellis, Terri A., Molina, Susan, Carl, Curtis, Kadry, Bassam, van Klei, Wilton A A, Pasma, Wietze, Jameson, Leslie C., Helsten, Daniel L., and Avidan, Michael S.

Subjects
Multicenter Study, Anesthesiology and Pain Medicine, Journal Article, Observational Study
Abstract

BACKGROUND:: Thrombocytopenia has been considered a relative or even absolute contraindication to neuraxial techniques due to the risk of epidural hematoma. There is limited literature to estimate the risk of epidural hematoma in thrombocytopenic parturients. The authors reviewed a large perioperative database and performed a systematic review to further define the risk of epidural hematoma requiring surgical decompression in this population. METHODS:: The authors performed a retrospective cohort study using the Multicenter Perioperative Outcomes Group database to identify thrombocytopenic parturients who received a neuraxial technique and to estimate the risk of epidural hematoma. Patients were stratified by platelet count, and those requiring surgical decompression were identified. A systematic review was performed, and risk estimates were combined with those from the existing literature. RESULTS:: A total of 573 parturients with a platelet count less than 100,000 mm who received a neuraxial technique across 14 institutions were identified in the Multicenter Perioperative Outcomes Group database, and a total of 1,524 parturients were identified after combining the data from the systematic review. No cases of epidural hematoma requiring surgical decompression were observed. The upper bound of the 95% CI for the risk of epidural hematoma for a platelet count of 0 to 49,000 mm is 11%, for 50,000 to 69,000 mm is 3%, and for 70,000 to 100,000 mm is 0.2%. CONCLUSIONS:: The number of thrombocytopenic parturients in the literature who received neuraxial techniques without complication has been significantly increased. The risk of epidural hematoma associated with neuraxial techniques in parturients at a platelet count less than 70,000 mm remains poorly defined due to limited observations.

Published
2017

4. Risk of Epidural Hematoma after Neuraxial Techniques in Thrombocytopenic Parturients: A Report from the Multicenter Perioperative Outcomes Group

Author

Medische staf Anesthesiologie, Circulatory Health, Management Vitale Functies, Trialbureau Vitale Functies, Lee, Linden O., Bateman, Brian T., Kheterpal, Sachin, Klumpner, Thomas T., Housey, Michelle, Aziz, Michael F., Hand, Karen W., MacEachern, Mark, Goodier, Christopher G., Bernstein, Jeffrey, Bauer, Melissa E., Lirk, Philip, Wilczak, Janet, Soto, Roy, Tom, Simon, Cuff, Germaine, Biggs, Daniel A., Coffman, Traci, Saager, Leif, Levy, Warren J., Godbold, Michael, Pace, Nathan L., Wethington, Kevin L., Paganelli, William C., Durieux, Marcel E., Domino, Karen B., Nair, Bala, Ehrenfeld, Jesse M., Wanderer, Jonathan P., Schonberger, Robert B., Berris, Joshua, Lins, Steven, Coles, Peter, Cummings, Kenneth C., Maheshwari, Kamal, Berman, Mitchell F., Wedeven, Christopher, LaGorio, John, Fleishut, Peter M., Ellis, Terri A., Molina, Susan, Carl, Curtis, Kadry, Bassam, van Klei, Wilton A A, Pasma, Wietze, Jameson, Leslie C., Helsten, Daniel L., Avidan, Michael S., Medische staf Anesthesiologie, Circulatory Health, Management Vitale Functies, Trialbureau Vitale Functies, Lee, Linden O., Bateman, Brian T., Kheterpal, Sachin, Klumpner, Thomas T., Housey, Michelle, Aziz, Michael F., Hand, Karen W., MacEachern, Mark, Goodier, Christopher G., Bernstein, Jeffrey, Bauer, Melissa E., Lirk, Philip, Wilczak, Janet, Soto, Roy, Tom, Simon, Cuff, Germaine, Biggs, Daniel A., Coffman, Traci, Saager, Leif, Levy, Warren J., Godbold, Michael, Pace, Nathan L., Wethington, Kevin L., Paganelli, William C., Durieux, Marcel E., Domino, Karen B., Nair, Bala, Ehrenfeld, Jesse M., Wanderer, Jonathan P., Schonberger, Robert B., Berris, Joshua, Lins, Steven, Coles, Peter, Cummings, Kenneth C., Maheshwari, Kamal, Berman, Mitchell F., Wedeven, Christopher, LaGorio, John, Fleishut, Peter M., Ellis, Terri A., Molina, Susan, Carl, Curtis, Kadry, Bassam, van Klei, Wilton A A, Pasma, Wietze, Jameson, Leslie C., Helsten, Daniel L., and Avidan, Michael S.

Published
2017

5. The Ligamentum Flavum

Author

Lirk, Philip, Reina, Miguel Angel, de Andres, Jose Antonio, Hadzic, Admir, Prats-Galino, Alberto, Sala-Blanch, Xavier, van Zundert, Andre A. J., Other Research, and Anesthesiology

Subjects
musculoskeletal diseases, medicine.medical_specialty, medicine.anatomical_structure, business.industry, medicine, Spinal anesthesia, Fluid injection, musculoskeletal system, business, Loss of resistance, Epidural space, Surgery
Abstract

Classically, anesthesiologists identify the epidural space using the “loss of resistance” technique. This method relies on the distinctive drop in resistance against needle advancement and fluid injection as the epidural needle is advanced through the ligamentum flavum. Knowledge of anatomy and of variations of the ligamentum flavum is essential in understanding the loss of resistance technique and its potential anatomic pitfalls.

Published
2015

7. Pilot study: Volatile organic compounds as a diagnostic marker for head and neck tumors.

Author

Schmutzhard, Joachim, Rieder, Josef, Deibl, Martina, Schwentner, Ilona M., Schmid, Stefan, Lirk, Philip, Abraham, Irene, and Gunkel, Andreas R.

Subjects
HEAD & neck cancer, VOLATILE organic compounds, SQUAMOUS cell carcinoma, MASS spectrometry
Abstract

Background In the last decade, the analysis of volatile organic compounds (VOC) has undergone a rapid development. In this pilot study, patients with HNSCC were tested with a proton transfer reaction-mass spectrometry in order to establish a minimal invasive screening method. Methods Overall in a period of 2 years, 22 carcinoma patients were recruited for the study. All patients had a newly diagnosed histologically secured squamous cell carcinoma of the upper aerodigestive tract. These results were statistically compared with 3 control groups: healthy controls, high-risk, and posttherapy patients. Results Two hundred nine different masses were measured; 188 of these were evaluated. The statistical workup of the 4 study groups produced 42 different masses, which showed a statistically significant difference from the carcinoma group compared with the control groups. Conclusion A screening method for HNSCC using VOC seems to be possible, but further investigation is necessary. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [ABSTRACT FROM AUTHOR]

Published
2008
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