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Article ; Online: Will Women's Careers Survive COVID-19?

Sibert, Karen S.

ASA Monitor

2020 Volume 84, Issue 9, Page(s) 20–21

Keywords	covid19
Language	English
Publisher	Ovid Technologies (Wolters Kluwer Health)
Publishing country	us
Document type	Article ; Online
ISSN	2380-4017
DOI	10.1097/01.asm.0000716964.40386.73
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Will Clinical Practice Guidelines Protect Against Malpractice Risk?

Sibert, Karen S

Maryland medicine : MM : a publication of MEDCHI, the Maryland State Medical Society

2015 Volume 16, Issue 1, Page(s) 12–14

MeSH term(s)	Evidence-Based Medicine/standards ; Malpractice/legislation & jurisprudence ; Malpractice/statistics & numerical data ; Malpractice/trends ; Physicians/legislation & jurisprudence ; Practice Guidelines as Topic ; Risk
Language	English
Publishing date	2015
Publishing country	United States
Document type	Journal Article
ZDB-ID	2015898-1
ISSN	1538-2656 ; 0025-4363
ISSN	1538-2656 ; 0025-4363
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Extubation and the Risks of Coughing and Laryngospasm in the Era of Coronavirus Disease-19 (COVID-19).

Sibert, Karen S / Long, Jennifer L / Haddy, Steven M

Cureus

2020 Volume 12, Issue 5, Page(s) e8196

Abstract: The coronavirus disease-19 (COVID-19) pandemic has prompted new interest among anesthesiologists and intensivists in controlling coughing and expectoration of potentially infectious aerosolized secretions during intubation and extubation. However, the ... ...

Abstract	The coronavirus disease-19 (COVID-19) pandemic has prompted new interest among anesthesiologists and intensivists in controlling coughing and expectoration of potentially infectious aerosolized secretions during intubation and extubation. However, the fear of provoking laryngospasm may cause avoidance of deep or sedated extubation techniques which could reduce coughing and infection risk. This fear may be alleviated with clear understanding of the mechanisms and effective management of post-extubation airway obstruction including laryngospasm. We review the dynamic function of the larynx from the vantage point of head-and-neck surgery, highlighting two key concepts: 1. The larynx is a complex organ that may occlude reflexively at levels other than the true vocal folds; 2. The widely held belief that positive-pressure ventilation by mask can "break" laryngospasm is not supported by the otorhinolaryngology literature. We review the differential diagnosis of acute airway obstruction after extubation, discuss techniques for achieving smooth extubation with avoidance of coughing and expectoration of secretions, and recommend, on the basis of this review, a clinical pathway for optimal management of upper airway obstruction including laryngospasm to avoid adverse outcomes.
Keywords	covid19
Language	English
Publishing date	2020-05-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.8196
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Extubation and the Risks of Coughing and Laryngospasm in the Era of Coronavirus Disease-19 (COVID-19)

Sibert, Karen S. / Long, Jennifer L. / Haddy, Steven M.

Cureus

Abstract	The coronavirus disease-19 (COVID-19) pandemic has prompted new interest among anesthesiologists and intensivists in controlling coughing and expectoration of potentially infectious aerosolized secretions during intubation and extubation However, the fear of provoking laryngospasm may cause avoidance of deep or sedated extubation techniques which could reduce coughing and infection risk This fear may be alleviated with clear understanding of the mechanisms and effective management of post-extubation airway obstruction including laryngospasm We review the dynamic function of the larynx from the vantage point of head-and-neck surgery, highlighting two key concepts: 1 The larynx is a complex organ that may occlude reflexively at levels other than the true vocal folds;2 The widely held belief that positive-pressure ventilation by mask can "break" laryngospasm is not supported by the otorhinolaryngology literature We review the differential diagnosis of acute airway obstruction after extubation, discuss techniques for achieving smooth extubation with avoidance of coughing and expectoration of secretions, and recommend, on the basis of this review, a clinical pathway for optimal management of upper airway obstruction including laryngospasm to avoid adverse outcomes
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #348024
Database	COVID19

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Article ; Online: Extubation and the Risks of Coughing and Laryngospasm in the Era of Coronavirus Disease-19 (COVID-19).

Sibert, Karen S / Long, Jennifer L / Haddy, Steven M

Cureus, vol 12, iss 5

2020

Abstract	The coronavirus disease-19 (COVID-19) pandemic has prompted new interest among anesthesiologists and intensivists in controlling coughing and expectoration of potentially infectious aerosolized secretions during intubation and extubation. However, the fear of provoking laryngospasm may cause avoidance of deep or sedated extubation techniques which could reduce coughing and infection risk. This fear may be alleviated with clear understanding of the mechanisms and effective management of post-extubation airway obstruction including laryngospasm. We review the dynamic function of the larynx from the vantage point of head-and-neck surgery, highlighting two key concepts: 1. The larynx is a complex organ that may occlude reflexively at levels other than the true vocal folds; 2. The widely held belief that positive-pressure ventilation by mask can "break" laryngospasm is not supported by the otorhinolaryngology literature. We review the differential diagnosis of acute airway obstruction after extubation, discuss techniques for achieving smooth extubation with avoidance of coughing and expectoration of secretions, and recommend, on the basis of this review, a clinical pathway for optimal management of upper airway obstruction including laryngospasm to avoid adverse outcomes.
Keywords	aerosol-generating procedures ; covid-19 ; deep extubation ; extubation ; functional anatomy of the larynx ; laryngospasm ; novel coronavirus ; partial airway obstruction ; stridor ; upper airway obstruction ; Medical and Health Sciences ; covid19
Subject code	610
Publishing date	2020-05-19
Publisher	eScholarship, University of California
Publishing country	us
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: An unusual cause of airway obstruction in a patient in the endoscopy suite.

Dhoon, Taizoon Q / Gerber, Jennifer L / Tran, Thuy B / Mahtabifard, Ali / Sibert, Karen S

A & A case reports

2014 Volume 3, Issue 2, Page(s) 15–19

Abstract: A 74-year-old man presented for outpatient endoscopy because of dysphagia and the sensation of a mass in the back of his throat. Esophagogastroduodenoscopy demonstrated a soft tissue mass in the proximal esophagus that prolapsed into the hypopharynx on ... ...

Abstract	A 74-year-old man presented for outpatient endoscopy because of dysphagia and the sensation of a mass in the back of his throat. Esophagogastroduodenoscopy demonstrated a soft tissue mass in the proximal esophagus that prolapsed into the hypopharynx on withdrawal of the endoscope. Complete airway obstruction ensued, requiring emergent tracheotomy. The patient was transferred to the hospital for further treatment. Surgical resection revealed a rare giant fibrovascular polyp, which may be associated with asphyxiation and sudden death.
Language	English
Publishing date	2014-07-15
Publishing country	United States
Document type	Journal Article
ISSN	2325-7237
ISSN (online)	2325-7237
DOI	10.1213/XAA.0000000000000040
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Machine-learning Algorithm to Predict Hypotension Based on High-fidelity Arterial Pressure Waveform Analysis.

Hatib, Feras / Jian, Zhongping / Buddi, Sai / Lee, Christine / Settels, Jos / Sibert, Karen / Rinehart, Joseph / Cannesson, Maxime

Anesthesiology

2018 Volume 129, Issue 4, Page(s) 663–674

Abstract: What we already know about this topic: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: With appropriate algorithms, computers can learn to detect patterns and associations in large data sets. The authors' goal was to apply machine learning to ... ...

Abstract	What we already know about this topic: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: With appropriate algorithms, computers can learn to detect patterns and associations in large data sets. The authors' goal was to apply machine learning to arterial pressure waveforms and create an algorithm to predict hypotension. The algorithm detects early alteration in waveforms that can herald the weakening of cardiovascular compensatory mechanisms affecting preload, afterload, and contractility. Methods: The algorithm was developed with two different data sources: (1) a retrospective cohort, used for training, consisting of 1,334 patients' records with 545,959 min of arterial waveform recording and 25,461 episodes of hypotension; and (2) a prospective, local hospital cohort used for external validation, consisting of 204 patients' records with 33,236 min of arterial waveform recording and 1,923 episodes of hypotension. The algorithm relates a large set of features calculated from the high-fidelity arterial pressure waveform to the prediction of an upcoming hypotensive event (mean arterial pressure < 65 mmHg). Receiver-operating characteristic curve analysis evaluated the algorithm's success in predicting hypotension, defined as mean arterial pressure less than 65 mmHg. Results: Using 3,022 individual features per cardiac cycle, the algorithm predicted arterial hypotension with a sensitivity and specificity of 88% (85 to 90%) and 87% (85 to 90%) 15 min before a hypotensive event (area under the curve, 0.95 [0.94 to 0.95]); 89% (87 to 91%) and 90% (87 to 92%) 10 min before (area under the curve, 0.95 [0.95 to 0.96]); 92% (90 to 94%) and 92% (90 to 94%) 5 min before (area under the curve, 0.97 [0.97 to 0.98]). Conclusions: The results demonstrate that a machine-learning algorithm can be trained, with large data sets of high-fidelity arterial waveforms, to predict hypotension in surgical patients' records.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Algorithms ; Arterial Pressure/physiology ; Female ; Humans ; Hypotension/diagnosis ; Hypotension/physiopathology ; Machine Learning ; Male ; Middle Aged ; Wavelet Analysis
Language	English
Publishing date	2018-06-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	269-0
ISSN	1528-1175 ; 0003-3022
ISSN (online)	1528-1175
ISSN	0003-3022
DOI	10.1097/ALN.0000000000002300
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Impact of Epidural Analgesia on the Rate of Thromboembolism without Chemical Thromboprophylaxis in Major Oncologic Surgery.

Manguso, Nicholas / Hong, Jenny / Shouhed, Daniel / Popelka, Sarah / Amersi, Farin / Hemaya, Emad / Sibert, Karen / Silberman, Allan W

The American surgeon

2018 Volume 84, Issue 6, Page(s) 851–855

Abstract: Patients with abdominopelvic cancers are at increased risk of venous thromboembolism (VTE) due to their malignancy. We evaluated outcomes and the rate of VTE in patients undergoing abdominopelvic surgery for malignancy with preoperative epidural ... ...

Abstract	Patients with abdominopelvic cancers are at increased risk of venous thromboembolism (VTE) due to their malignancy. We evaluated outcomes and the rate of VTE in patients undergoing abdominopelvic surgery for malignancy with preoperative epidural analgesia without postoperative chemical VTE prophylaxis. A retrospective review between 2009 and 2015 identified 285 patients with malignancy who underwent abdominopelvic surgery by a single surgeon (AWS). Lower extremity venous duplex scans (VDS) were performed preoperatively and before discharge. Demographics, procedures, and VTE outcomes were reviewed. The median age was 66 years. The average operative time was 315 minutes. All patients ambulated on postoperative day (POD) one or two. Epidural catheters (ECs) were removed on postoperative day four or five. No patient received VTE prophylaxis while an epidural catheter was in place. Preoperative lower extremity VDS revealed above-knee deep vein thrombosis (DVT) in seven patients (2.5%). Postoperative lower extremity VDS revealed acute DVT in 24 patients (8.4%): nine (3.2%) above-knee and 15 (5.2%) below-knee. The nine patients with above-knee DVT were anticoagulated after epidural removal. No patient developed a pulmonary embolism. Our data suggest that patients undergoing major open operations with epidural analgesia have low rates of DVT and may obviate the need for chemical prophylaxis. However, larger studies are required to determine the overall effects of epidural analgesia on the development of DVTs postoperatively.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Analgesia, Epidural ; Digestive System Neoplasms/surgery ; Female ; Humans ; Male ; Middle Aged ; Pelvic Neoplasms/surgery ; Postoperative Complications/epidemiology ; Retrospective Studies ; Venous Thromboembolism/epidemiology ; Young Adult
Language	English
Publishing date	2018-06-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Tumors at the aortoiliac/inferior vena cava bifurcation: preoperative, anesthetic, and intraoperative considerations.

Ouellette, James R / Cossman, David V / Sibert, Karen S / Mcandrew, Nicholas P / Silberman, Allan W

The American surgeon

2007 Volume 73, Issue 5, Page(s) 440–446

Abstract: Primary and recurrent retroperitoneal tumors can involve the aortoiliac vasculature. They are often considered inoperable or incurable because of the locally advanced nature of the disease or the technical aspects involved in safely resecting the lesion. ...

Abstract	Primary and recurrent retroperitoneal tumors can involve the aortoiliac vasculature. They are often considered inoperable or incurable because of the locally advanced nature of the disease or the technical aspects involved in safely resecting the lesion. Safe resection of these lesions requires experience and extensive preoperative planning for success. A retrospective database review of 76 patients with retroperitoneal tumors identified tumors involving major vascular structures in the abdomen and pelvis undergoing resection of tumor en bloc with the aortoiliac vasculature. Preoperative planning and intraoperative technical maneuvers are reviewed. Patients were followed until time of this report. Four patients with retroperitoneal tumors involving the aortoiliac vessels underwent surgery: two patients with sarcoma (one primary and one recurrent), one with metastatic renal cell carcinoma, and one with a paraganglioma. All patients had resection of the aorta and vena cava or the iliac artery and vein. Arterial reconstruction (anatomic or extra-anatomic) was performed in all cases. The patient with renal cell carcinoma also required venous reconstruction to support a renal autotransplant. Veno-venous bypass was required in one patient. Local control was achieved in 3 of 4 cases. Surgery for retroperitoneal tumors involving major vascular structures is technically feasible with appropriate planning and technique. Multiple disciplines are required, including general surgical oncology, vascular surgery, and possibly, cardiothoracic surgery.
MeSH term(s)	Adult ; Aorta, Abdominal ; Carcinoma, Renal Cell/blood supply ; Carcinoma, Renal Cell/secondary ; Carcinoma, Renal Cell/surgery ; Female ; Humans ; Kidney Neoplasms/pathology ; Male ; Middle Aged ; Paraganglioma/blood supply ; Paraganglioma/pathology ; Paraganglioma/surgery ; Retroperitoneal Neoplasms/blood supply ; Retroperitoneal Neoplasms/pathology ; Retroperitoneal Neoplasms/surgery ; Sarcoma/blood supply ; Sarcoma/pathology ; Sarcoma/surgery ; Vascular Surgical Procedures/methods ; Vena Cava, Inferior
Language	English
Publishing date	2007-05
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Genome maps across 26 human populations reveal population-specific patterns of structural variation.

Levy-Sakin, Michal / Pastor, Steven / Mostovoy, Yulia / Li, Le / Leung, Alden K Y / McCaffrey, Jennifer / Young, Eleanor / Lam, Ernest T / Hastie, Alex R / Wong, Karen H Y / Chung, Claire Y L / Ma, Walfred / Sibert, Justin / Rajagopalan, Ramakrishnan / Jin, Nana / Chow, Eugene Y C / Chu, Catherine / Poon, Annie / Lin, Chin /

Naguib, Ahmed / Wang, Wei-Ping / Cao, Han / Chan, Ting-Fung / Yip, Kevin Y / Xiao, Ming / Kwok, Pui-Yan

Nature communications

2019 Volume 10, Issue 1, Page(s) 1025

Abstract: Large structural variants (SVs) in the human genome are difficult to detect and study by conventional sequencing technologies. With long-range genome analysis platforms, such as optical mapping, one can identify large SVs (>2 kb) across the genome in one ...

Abstract	Large structural variants (SVs) in the human genome are difficult to detect and study by conventional sequencing technologies. With long-range genome analysis platforms, such as optical mapping, one can identify large SVs (>2 kb) across the genome in one experiment. Analyzing optical genome maps of 154 individuals from the 26 populations sequenced in the 1000 Genomes Project, we find that phylogenetic population patterns of large SVs are similar to those of single nucleotide variations in 86% of the human genome, while ~2% of the genome has high structural complexity. We are able to characterize SVs in many intractable regions of the genome, including segmental duplications and subtelomeric, pericentromeric, and acrocentric areas. In addition, we discover ~60 Mb of non-redundant genome content missing in the reference genome sequence assembly. Our results highlight the need for a comprehensive set of alternate haplotypes from different populations to represent SV patterns in the genome.
MeSH term(s)	Algorithms ; Base Sequence ; Chromosome Mapping/methods ; Chromosomes, Human, Y ; Computational Biology ; Female ; Gene Dosage ; Genetic Linkage ; Genome, Human ; Genomic Structural Variation ; Genomics ; Humans ; Male ; Mutation ; Phylogeny ; Segmental Duplications, Genomic/genetics ; Sequence Analysis, DNA
Language	English
Publishing date	2019-03-04
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-019-08992-7
Database	MEDical Literature Analysis and Retrieval System OnLINE

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