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Artikel: Intraoperative Capnothorax during Robotic Diaphragmatic Endometriosis Excision.

Dunn, Tyler / Misra, Lopa

2022 Band 2022, Seite(n) 5935312

Abstract: Laparoscopic surgery is performed quite commonly and is known to have numerous advantages over traditional open surgery. Albeit rare, there are life-threatening complications as a result of laparoscopic surgery including those associated with the ... ...

Abstract	Laparoscopic surgery is performed quite commonly and is known to have numerous advantages over traditional open surgery. Albeit rare, there are life-threatening complications as a result of laparoscopic surgery including those associated with the cardiopulmonary system. In our case, we present hemodynamically unstable capnothorax that occurred during robotic diaphragmatic endometriosis excision which was treated conservatively. It is critical for anesthesia providers to recognize when capnothorax occurs and to understand the implications and treatment in order to minimize unnecessary procedures and morbidity associated with such.
Sprache	Englisch
Erscheinungsdatum	2022-04-26
Erscheinungsland	United States
Dokumenttyp	Case Reports
ZDB-ID	2659087-6
ISSN	2090-6390 ; 2090-6382
ISSN (online)	2090-6390
ISSN	2090-6382
DOI	10.1155/2022/5935312
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Unilateral Hypoglossal Nerve Palsy in a Patient with a Difficult Airway Requiring Prolonged Intubation.

Leuzinger, Kahlin / Misra, Lopa

Case reports in anesthesiology

2021 Band 2021, Seite(n) 8842503

Abstract: Isolated cranial nerve injury is a very rare complication of anesthesia. Specifically, hypoglossal nerve palsy affects mobility of the tongue and basic functions of swallowing and speech, and injury can be associated with placement and/or positioning of ... ...

Abstract	Isolated cranial nerve injury is a very rare complication of anesthesia. Specifically, hypoglossal nerve palsy affects mobility of the tongue and basic functions of swallowing and speech, and injury can be associated with placement and/or positioning of the endotracheal tube. Many etiologies are described that are unrelated to anesthesia such as tumors, stroke, trauma, or surgical dissection. Identification of hypoglossal neuropraxic-type injury from compression or stretching during anesthetic procedures can be difficult and tends to be a diagnosis of exclusion. Here, we present a case of a unilateral isolated hypoglossal nerve palsy following prolonged intubation in a surgery that involved large fluid shifts resulting in tongue swelling, in which establishment of the airway was initially difficult requiring two attempts. We suggest it is equally as possible that stretch injury occurred during airway instrumentation versus prolonged compression of the nerve between the endotracheal tube and the hyoid bone, possibly relating to a swollen tongue. We outline some treatments that have been used in previous reports and analyze their relation to improvements in symptoms. We conclude that instrumentation of the airway and prolonged intubation are both potential risk factors for hypoglossal nerve palsy, and identification of these risk factors can improve patient care by prompting patient discussions, guiding intraoperative management, and initiating earlier therapies.
Sprache	Englisch
Erscheinungsdatum	2021-02-18
Erscheinungsland	United States
Dokumenttyp	Case Reports
ZDB-ID	2659087-6
ISSN	2090-6390 ; 2090-6382
ISSN (online)	2090-6390
ISSN	2090-6382
DOI	10.1155/2021/8842503
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Women Authorship Trends in the Highest-Impact Anesthesiology Journals from 2005 to 2021.

Keim, Audrey A / Pelkey, Melissa N / Broadfoot, Jourdan E / Folley, Tarrah A / Kraus, Molly B / Maloney, Jillian A / Strand, Natalie H / Misra, Lopa

Journal of women's health (2002)

2023 Band 32, Heft 5, Seite(n) 592–597

Abstract: Background: ...

Abstract	Background:
Mesh-Begriff(e)	Humans ; Male ; Female ; Anesthesiology ; Pandemics ; Sexism ; COVID-19 ; Periodicals as Topic
Sprache	Englisch
Erscheinungsdatum	2023-01-13
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	1139774-3
ISSN	1931-843X ; 1059-7115 ; 1540-9996
ISSN (online)	1931-843X
ISSN	1059-7115 ; 1540-9996
DOI	10.1089/jwh.2022.0532
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Matters of the Heart: Examining Motivating Factors and Unconscious Bias in the Adult Cardiothoracic Anesthesiology Fellowship.

Yu, Soojie / Tavarez-Mora, Frank / Milam, Adam J / Misra, Lopa / Aljure, Oscar / Glas, Kathryn / Shillcutt, Sasha

Journal of cardiothoracic and vascular anesthesia

2023 Band 37, Heft 7, Seite(n) 1160–1168

Abstract: Objectives: The purpose of this study was to identify barriers to improving diversity within adult cardiothoracic anesthesiology (ACTA) and to provide possible strategies that could be implemented by evaluating the demographics of current ACTA fellows, ... ...

Abstract	Objectives: The purpose of this study was to identify barriers to improving diversity within adult cardiothoracic anesthesiology (ACTA) and to provide possible strategies that could be implemented by evaluating the demographics of current ACTA fellows, examining motivating factors to pursue the sub-specialty, and assessing perceptions of unconscious biases during their application process and training. Design: A survey was created by the authors and distributed electronically by the Society of Cardiovascular Anesthesiologists to the ACTA Fellows from April to June 2022. Setting: A multicenter survey. Participants: Recent 2021 to 2022 ACTA fellows. Interventions: None. Measurements and main results: A total of 68 fellows were included in the analytical sample; 37.3% were women, and 58.2% were men. Half of the participants in the sample were White race (47%), 26% were Asian, 8% Hispanic or Latinx, 5% Black, and 2% were Pacific Islander or Native Hawaiian. Most fellows indicated that the complexity of cases and/or competency in transesophageal echocardiography was "very important" in their motivating factor (74.0%). When examining sex differences, female fellows reported (p value <0.05) that their experience was impacted negatively by sex and was more often treated with less respect and courtesy. There were no statistically significant differences in perceived discrimination by race and/or ethnicity. Conclusions: This study identified several motivators to pursue ACTA and the perceptions of unconscious biases during the fellowship. Female fellows felt unconscious bias and a negative impact against them due to sex. Due to the small number of undergraduate enrollments, the results should be interpreted cautiously. Additionally, this provides support to complete further studies. Implicit bias training is one strategy that can be implemented to decrease unconscious bias experienced by ACTA fellows.
Mesh-Begriff(e)	Adult ; Female ; Humans ; Male ; Anesthesiology/education ; Bias, Implicit ; Ethnicity ; Fellowships and Scholarships
Sprache	Englisch
Erscheinungsdatum	2023-03-06
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2023.02.044
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Racial Disparities in Compensation Among US Anesthesiologists: Results of a National Survey of Anesthesiologists.

Vandenberg, Megan T / Kraus, Molly / Misra, Lopa / Hertzberg, Linda / Buckner-Petty, Skye / Padmanabhan, Asha / Tollinche, Luis E / Milam, Adam J

Anesthesia and analgesia

2023 Band 137, Heft 2, Seite(n) 268–276

Abstract: Background: A racial compensation disparity among physicians across numerous specialties is well documented and persists after adjustment for age, sex, experience, work hours, productivity, academic rank, and practice structure. This study examined ... ...

Abstract	Background: A racial compensation disparity among physicians across numerous specialties is well documented and persists after adjustment for age, sex, experience, work hours, productivity, academic rank, and practice structure. This study examined national survey data to determine whether there are racial differences in compensation among anesthesiologists in the United States. Methods: In 2018, 28,812 active members of the American Society of Anesthesiologists were surveyed to examine compensation among members. Compensation was defined as the amount reported as direct compensation on a W-2, 1099, or K-1, plus all voluntary salary reductions (eg, 401[k], health insurance). Covariates potentially associated with compensation were identified (eg, sex and academic rank) and included in regression models. Racial differences in outcome and model variables were assessed via Wilcoxon rank sum tests and Pearson's χ 2 tests. Covariate adjusted ordinal logistic regression estimated an odds ratio (OR) for the relationship between race and ethnicity and compensation while adjusting for provider and practice characteristics. Results: The final analytical sample consisted of 1952 anesthesiologists (78% non-Hispanic White). The analytic sample represented a higher percentage of White, female, and younger physicians compared to the demographic makeup of anesthesiologists in the United States. When comparing non-Hispanic White anesthesiologists with anesthesiologists from other racial and ethnic minority groups, (ie, American Indian/Alaska Native, Asian, Black, Hispanic, and Native Hawaiian/Pacific Islander), the dependent variable (compensation range) and 6 of the covariates (sex, age, spousal work status, region, practice type, and completed fellowship) had significant differences. In the adjusted model, anesthesiologists from racial and ethnic minority populations had 26% lower odds of being in a higher compensation range compared to White anesthesiologists (OR, 0.74; 95% confidence interval [CI], 0.61-0.91). Conclusions: Compensation for anesthesiologists showed a significant pay disparity associated with race and ethnicity even after adjusting for provider and practice characteristics. Our study raises concerns that processes, policies, or biases (either implicit or explicit) persist and may impact compensation for anesthesiologists from racial and ethnic minority populations. This disparity in compensation requires actionable solutions and calls for future studies that investigate contributing factors and to validate our findings given the low response rate.
Mesh-Begriff(e)	Female ; Humans ; Anesthesiologists ; Asian ; Ethnicity/statistics & numerical data ; Hispanic or Latino ; Minority Groups ; United States/epidemiology ; Salaries and Fringe Benefits/economics ; Salaries and Fringe Benefits/statistics & numerical data ; Anesthesiology/economics ; Anesthesiology/statistics & numerical data ; Race Factors/economics ; Race Factors/statistics & numerical data ; Black or African American ; White ; American Indian or Alaska Native ; Native Hawaiian or Other Pacific Islander
Sprache	Englisch
Erscheinungsdatum	2023-07-14
Erscheinungsland	United States
Dokumenttyp	Comparative Study ; Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006484
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Diversity, Equity, and Inclusion Among Anesthesiology Trainees.

Patel, Shyam / Lin, Keldon K / Milam, Adam J / Yu, Soojie / Raynor, Gwendolyn / Narjeet, Khurmi / Verdiner, Ricardo / Girardo, Marlene E / Misra, Lopa

Women's health reports (New Rochelle, N.Y.)

2022 Band 3, Heft 1, Seite(n) 414–419

Abstract: Background: Historically in medicine, women and minorities have been underrepresented. This trend is especially significant in the anesthesiology workforce.: Objective: The goals of this study were to quantify the current state of diversity by race/ ... ...

Abstract	Background: Historically in medicine, women and minorities have been underrepresented. This trend is especially significant in the anesthesiology workforce. Objective: The goals of this study were to quantify the current state of diversity by race/ethnicity, gender, and sexual orientation among anesthesiology residents. Methods: An institutionally reviewed and validated survey was delivered through Qualtrics to 130 anesthesiology program directors. Topics addressed included gender identity, sexual orientation, racial and ethnic background, rationale for pursuing anesthesiology, and medical training experiences. The study was administered from February to April 2021; 135 anesthesiology residents responded to the survey. Results: The sample was 44.4% white ( Conclusions: Experiences of discrimination based on race/ethnicity, gender, and gender identity continues to be a concern among anesthesiology trainees. Creating an environment that is inclusive and supportive of all trainees regardless of race/ethnicity, gender/gender identity, and sexual orientation is needed. Interventions and strategies to create an inclusive environment may improve diversity within anesthesiology.
Sprache	Englisch
Erscheinungsdatum	2022-04-07
Erscheinungsland	United States
Dokumenttyp	Journal Article
ISSN	2688-4844
ISSN (online)	2688-4844
DOI	10.1089/whr.2021.0123
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Administering Anesthesia for Patients with ALS Having a Diaphragmatic Pacemaker Placed

Molly Kraus / Lopa Misra

Open Journal of Anesthesiology , Vol 04, Iss 09, Pp 223-

Special Considerations

2014 Band 226

Abstract: Amyotrophic lateral sclerosis (ALS) also known as Lou Gehrig’s disease is a relentlessly progressive, fatal disease. Progression of the disease results 3 - 5 years after diagnosis, often from respiratory failure. The diaphragm pacing system (DPS) is a ... ...

Abstract	Amyotrophic lateral sclerosis (ALS) also known as Lou Gehrig’s disease is a relentlessly progressive, fatal disease. Progression of the disease results 3 - 5 years after diagnosis, often from respiratory failure. The diaphragm pacing system (DPS) is a device that stimulates the diaphragm to maximally contract so patients can breathe more effectively. It has been used in patients with neurologic injuries such as spinal cord injury and ALS. From an anesthetic perspective, both the surgery and the patient population present several unique challenges. This case series describes three patients with ALS who had the diaphragmatic pacemaker placed and the anesthetic management during those surgeries.
Schlagwörter	ALS ; Amyotrophic Lateral Sclerosis ; Diaphragmatic Pacemaker ; DPS ; Lou Gehrig’s Disease ; Anesthesiology ; RD78.3-87.3 ; Surgery ; RD1-811 ; Medicine ; R
Sprache	Englisch
Erscheinungsdatum	2014-09-01T00:00:00Z
Verlag	Scientific Research Publishing
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel ; Online: Lateral popliteal block in foot and ankle surgery: Comparing ultrasound guidance to nerve stimulation. A prospective randomized trial.

Sagherian, Bernard H / Kile, Todd A / Seamans, David P / Misra, Lopa / Claridge, Richard J

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons

2020 Band 27, Heft 2, Seite(n) 175–180

Abstract: Background: The popliteal block has several benefits in foot and ankle surgery. It reduces postoperative pain, limits the use of narcotics and facilitates early discharge. The aim of this prospective randomized trial was to evaluate whether ultrasound ... ...

Abstract	Background: The popliteal block has several benefits in foot and ankle surgery. It reduces postoperative pain, limits the use of narcotics and facilitates early discharge. The aim of this prospective randomized trial was to evaluate whether ultrasound guidance improves block characteristics compared to the nerve stimulation technique in lateral popliteal blocks. Methods: Patients were randomized to receive either a lateral popliteal block using neurostimulation or ultrasound guidance. Block performance time, number of needle pricks, number of redirections were recorded. Pain upon admission to and discharge from post anesthesia care unit (PACU) was recorded. Block duration, patient satisfaction, pain at block site and amount of opioids used in PACU and between subsequent followup visits was recorded. Patients were followed for 12 weeks postoperatively. Results: There was no statistically significant difference between the two groups in terms of number of pricks, time for the block to wean, pain upon admission to PACU, amount of opioids received in PACU, pain upon discharge from PACU, pain at the operative site, pain at the block site, toe motor function and toe sensation. There was a statistically significant difference in the block procedure performance time between the two groups, with the control group being faster (P<0.0001). A significantly larger number of patients in the control group required more than three needle redirections (P=0.0060). Conclusions: The lateral sciatic popliteal block using nerve stimulation had similar block characteristics and patient satisfaction with a significantly faster performance time compared to the ultrasound guided technique. Level of evidence: Level I, prospective randomized study.
Mesh-Begriff(e)	Adult ; Aged ; Analgesics, Opioid/therapeutic use ; Ankle/innervation ; Ankle/surgery ; Electric Stimulation ; Female ; Foot/innervation ; Foot/surgery ; Humans ; Male ; Middle Aged ; Nerve Block/methods ; Pain Measurement ; Pain, Postoperative/prevention & control ; Prospective Studies ; Ultrasonography, Interventional
Chemische Substanzen	Analgesics, Opioid
Sprache	Englisch
Erscheinungsdatum	2020-04-17
Erscheinungsland	France
Dokumenttyp	Journal Article ; Randomized Controlled Trial
ZDB-ID	1424533-4
ISSN	1460-9584 ; 1268-7731
ISSN (online)	1460-9584
ISSN	1268-7731
DOI	10.1016/j.fas.2020.03.011
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Perioperative considerations for patients with sickle cell disease: a narrative review.

Khurmi, Narjeet / Gorlin, Andrew / Misra, Lopa

Canadian journal of anaesthesia = Journal canadien d'anesthesie

2017 Band 64, Heft 8, Seite(n) 860–869

Abstract: Purpose: Approximately 200,000 individuals worldwide are born annually with sickle cell disease (SCD). Regions with the highest rates of SCD include Africa, the Mediterranean, and Asia, where its prevalence is estimated to be 2-6% of the population. An ... ...

Titelübersetzung	Considérations périopératoires pour les patients atteints d’anémie falciforme : un compte rendu narratif.
Abstract	Purpose: Approximately 200,000 individuals worldwide are born annually with sickle cell disease (SCD). Regions with the highest rates of SCD include Africa, the Mediterranean, and Asia, where its prevalence is estimated to be 2-6% of the population. An estimated 70,000-100,000 people in the United States have SCD. Due to enhanced newborn screening, a better understanding of this disease, and more aggressive therapy, many sickle cell patients survive into their adult years and present more frequently for surgery. Source: The authors identified relevant medical literature by searching PubMed, MEDLINE®, EMBASE™, Scopus™, Web of Science, and Google Scholar databases for English language publications appearing from 1972-September 2016. Case reports, abstracts, review articles, and original research articles were reviewed-with particular focus on the pathophysiology and medical management of SCD and any anesthesia-related issues. Principal findings: Perioperative physicians should be familiar with the triggers of a sickle cell crisis and vaso-occlusive disease. Sickle cell disease affects various organ systems, including the central nervous, cardiovascular, pulmonary, genitourinary, and musculoskeletal systems. Preoperative assessment should focus on end-organ dysfunction. Controversy continues regarding if and when sickle cell patients should receive transfusions and which anesthetic technique (regional or general) confers any benefits. Timely, appropriate, and sufficient analgesia is critical, especially when patients experience a vaso-occlusive crisis, acute chest syndrome, or acute postoperative pain. Conclusion: Effective management of SCD patients in the perioperative setting requires familiarity with the epidemiology, pathophysiology, clinical manifestations, and treatment of SCD.
Sprache	Englisch
Erscheinungsdatum	2017-08
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	91002-8
ISSN	1496-8975 ; 0832-610X
ISSN (online)	1496-8975
ISSN	0832-610X
DOI	10.1007/s12630-017-0883-3
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Angioedema

Lopa Misra / Narjeet Khurmi / Terrence L Trentman

Indian Journal of Anaesthesia, Vol 60, Iss 8, Pp 534-

Classification, management and emerging therapies for the perioperative physician

2016 Band 541

Abstract: Angioedema is a rare condition which manifests as sudden localised, non-pitting swelling of certain body parts including skin and mucous membranes. It is vital that anaesthesiologists understand this condition, as it may present suddenly in the ... ...

Abstract	Angioedema is a rare condition which manifests as sudden localised, non-pitting swelling of certain body parts including skin and mucous membranes. It is vital that anaesthesiologists understand this condition, as it may present suddenly in the perioperative period with airway compromise. To identify literature for this review, the authors searched the PubMed, Medline, Embase, Scopus and Web of Science databases for English language articles covering a 10-year period, 2006 through 2016. Angioedema can be either mast-cell mediated or bradykinin-induced. Older therapies for histaminergic symptoms are well known to anaesthesiologists (e.g., adrenaline, anti-histamines and steroids), whereas older therapies for bradykinin-induced symptoms include plasma and attenuated androgens. New classes of drugs for bradykinin-induced symptoms are now available, including anti-bradykinin, plasma kallikrein inhibitor and C1 esterase inhibitors. These can be used prophylactically or as rescue medications. Anaesthesiologists are in a unique position to coordinate perioperative care for this complex group of patients.
Schlagwörter	Airway ; angioedema ; bradykinin ; C1 esterase inhibitor ; histamine ; Anesthesiology ; RD78.3-87.3 ; Surgery ; RD1-811 ; Medicine ; R
Sprache	Englisch
Erscheinungsdatum	2016-01-01T00:00:00Z
Verlag	Wolters Kluwer Medknow Publications
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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