Prospectively evaluate peripheral nerve blocks as a primary anesthetic in the setting of above-the-knee amputations.

All enrollees will be administered Intravenous sedatives using propofol or dexmedetomidine and have ultrasound-guided femoral and sciatic nerve blocks placed per current practice at research site. Single-injection obturator nerve blocks and lateral femoral cutaneous nerve blocks will also be performed.

All enrollees will have ultrasound-guided femoral and sciatic nerve blocks placed per current practice at research site. Single-injection obturator and lateral femoral cutaneous nerve blocks will also be performed.

Peripheral nerve block

Intravenous sedation using propofol or dexmedetomidine will be administered.

Intravenous Sedatives

After administration of intravenous sedation, lateral femoral cutaneous and obturator nerve blocks (in addition to the femoral and sciatic catheters) will be performed under ultrasound guidance.

Lateral femoral cutaneous nerve blocks

Obturator nerve blocks

Aortic valve replacement with bioprosthesis according to indications in the current guidelines for the management of valvular heart disease including surgical closure of left atrial appendage

aortic valve replacement with bioprosthesis according to indications in the current guidelines for the management of valvular heart disease. The operation as well as the pre and post-operative care will be performed according to local surgical policies.

Surgical closure of left atrial appendage

Aortic valve replacement with bioprosthesis according to indications in the current guidelines for the management of valvular heart disease.

aortic valve replacement with bioprosthesis according to indications in the current guidelines for the management of valvular heart disease.

No closure of left atrial appendage

Fetuses with Left CDH (O/E LHR \< 25%) will receive Fetoscopic Endoluminal Tracheal Occlusion (FETO)

This study will position and remove an endoluminal tracheal balloon in utero (FETO) to study the feasibility of implementing FETO therapy in the most severe group of fetuses with left CDH (O/E \< 25%; O/E LHR \< 30 %) and right CDH (O/E LHR \< 45%).

Fetoscopic Endoluminal Tracheal Occlusion (FETO)

Fetuses with Left CDH (O/E LHR \< 30%) will receive Fetoscopic Endoluminal Tracheal Occlusion (FETO)

Fetuses with Right CDH (O/E LHR \< 45%) will receive Fetoscopic Endoluminal Tracheal Occlusion (FETO)

Elizabeth Torres

Sarkis Derderian, MD

Michael Zaretsky, MD

All subjects will be treated with the FUSION closed loop glucose control system for up to 24 hours

The FUSION system will be used to control the subjects glucose to a range of 100-140 mg/dL. Data will be collected for up to 24 hours, or upon early termination of the study session.

Fusion closed loop glucose control system

In patients randomized to standard, only the nodal packet under the external iliac vein and above the obturator nerve will be dissected. For patients randomized to the modified template, the external iliac, hypogastric and obturator fossa nodal groups will be removed.No lymph nodes will be removed in patients randomized to the no PLND arm.

Inclusion of the external iliac, hypogastric and obturator fossa nodal groups in the template undergoing a Radical Prostatectomy. Modifying the template for lymph node dissection may lead to removal of additional affected nodes, reducing the chance of recurrence. .No lymph nodes will be removed in patients randomized to the no PLND arm.

Lymph node template

Transverse versus vertical closure of the port site incision

Transverse versus vertical closure

One vs. three days of antibiotic prophylaxis at catheter removal

antibiotic prophylaxis

For the patients randomized to routine indwelling HA agent use, the operating surgeon may choose to use either Surgicel™, Surgicel SNoW™, Arista™, FloSeal or surgeon's choice HA directed at the prostatic fossa, ligated dorsal vein complex, or neurovascular bundles. Because there is no standard HA or method of application, the surgeon will apply the HA according to the surgeon's experience and document both the HA used, and the location applied in the operative report. For patients randomized to no routine indwelling HA use, surgeons will only apply a HA if they are unable to achieve hemostasis using traditional means or feel it would be unsafe to complete the operation without using a HA for additional hemostasis. Providers in either arm may use HA as needed provided the intention is not to leave the HA indwelling.

Hemostatic Agent

Cases that will undergo Fetoscopic Endoluminal Tracheal Occlusion (FETO) procedure.

FETO procedure involves insertion of a balloon into the fetal trachea under IV sedation with local anesthesia or combined spinal-epidural anesthesia. Balloon removal will take place up to 7 weeks after insertion.

Fetoscopic Endoluminal Tracheal Occlusion (FETO) Procedure

Cases that meet study inclusion criteria but voluntarily decline the Fetoscopic Endoluminal Tracheal Occlusion (FETO) procedure. These cases will undergo the standard of clinical care.

Fetal Endoluminal Tracheal Occlusion with Balloon placement for fetuses with congenital diaphragmatic hernia

FETO, Fetal Endoluminal Tracheal Occlusion

Children's Hospital Medical Center, Cincinnati

Foong-Yen Lim

Erin Watters

Foong Yen Lim

Participants receiving SaMBA-COPD intervention by community health workers (CHW).

Participants will receive comprehensive screening and targeted management of barriers to COPD control, incorporating home-based pulmonary rehabilitation, oral steroid and antibiotic prescribing for pre-emptive treatment of COPD exacerbations.

The intervention will be delivered by CHWs in person and supplemented with telephone or video encounters over 6 months. The intervention comprises six core elements: engagement, intake, self-management assessment, barrier screening, actions to address identified barriers, and follow-up/maintenance support.

Self-Management Support

Participants will receive support by CHWs providing education using the COPD 1-2-3 booklet. Participants will receive similar visit frequencies but will not undergo barrier screening or targeted interventions.

The attention control is where CHWs will provide COPD education using the COPD 1-2-3 booklet. The attention control will consist of 6 CHW visits (approximately 1 per month) with the patient and care giver in their home or via video conference, per patient preference.

말초신경 차단술, 정맥 진정제, 외측 대퇴부 피부신경 차단술, 폐쇄근 신경 차단술

좌심방 부속기의 수술적 폐쇄, 좌심방 부속기 폐쇄 없음

태아경 기관내강 폐쇄술(FETO)

퓨전 폐쇄 루프 포도당 제어 시스템

림프절 템플릿, 횡적 폐쇄 대 수직 폐쇄, 항생제 예방, 지혈제

태아경 기관내 폐쇄술(FETO) 시술

FETO, 태아 기관내강 폐쇄

자기관리 지원, 만성폐쇄성폐질환(COPD) 교육