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An online calculator that assesses patient-specific risk and guides surgical decision making changes the perceptions that surgeons have about operative risk, but not their decisions to recommend surgery, according to a randomized controlled trial. The surgical risk calculator developed by the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP), has a “high degree […]
Read MoreWhen compared with usual care, treatment of recent-onset low back pain (LBP) with early physical therapy resulted in a statistically significant improvement in disability, but the benefit was not clinically significant, according to results from a randomized clinical trial published in the October 13 issue of JAMA. Julie M. Fritz, PhD, PT, from the University of […]
Read MoreThe use of imaging for uncomplicated headache and cardiac stress imaging for low-risk patients has declined significantly during the last few years with the implementation of the American Board of Internal Medicine Foundation’s Choosing Wisely campaign. Launched in 2012, Choosing Wisely was designed to make physicians aware of commonly overused medical procedures by publishing lists […]
Read MoreTransfusion 2015 Oct 7. doi: 10.1111/trf.13366. Authors: Eichel Y et al BACKGROUND: Mutations of nonmuscle myosin heavy chain 9 (MYH9) gene are an autosomal dominant cause of inherited thrombocytopenia in children. MYH9 spectrum disorders include May-Hegglin anomaly and Sebastian, Fechtner, and Epstein syndromes. Patients with these disorders often present with macroplatelets and thrombocytopenia and have a mild […]
Read MoreReviewed By: Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California San Francisco An intra-articular corticosteroid injection into the temporomandibular joint (TMJ) provides pain relief for some patients with juvenile idiopathic arthritis (JIA) whose orofacial symptoms haven’t responded to other pain management strategies. Note that the study identified considerable variation in terms of […]
Read MoreAnesthesia & Analgesia: Jan 2016 Vol 122 Issue 1 p226-233 Authors: Bombardieri, Anna Maria MD, PhD et al BACKGROUND: Hypotensive epidural anesthesia (HEA), as practiced at our institution, uses sympathetic blockade to achieve mean arterial blood pressure (MAP) of ≤50 mm Hg while administering epinephrine by infusion to support the circulation. HEA has not been associated […]
Read MoreAnesthesia & Analgesia:Dec 2015 Volume 121 Issue 6 p1443-1455 Authors: Zhou, Xuelong MD et al BACKGROUND: Previous studies have evaluated the efficacy of preoperative acute normovolemic hemodilution (PANH) in reducing the need for allogeneic blood transfusion. However, the results to date have been controversial. In this study, we sought to reassess the efficacy and safety […]
Read MoreAnesthesia & Analgesia: Dec 2045 Volume 121-Issue 6 p1500-1507 Authors: Panjasawatwong, Krit MD et al BACKGROUND: Intraoperative hypotension is associated with complications that might be ameliorated by earlier intervention. We therefore tested the primary hypothesis that a supplemental decision support alert for critically low systolic blood pressure (SBP) decreases the duration of intraoperative hypotension. METHODS: […]
Read MoreNeural blockade of the thoracolumbar nerves supplying the anterior abdominal wall through transversus abdominis plane (TAP) has been investigated for different applications mainly for the acute pain management following abdominal surgical procedures. The role of this block for chronic pain syndromes is still to be discovered, and its value in chronic abdominal pain needs to […]
Read MoreA recent CDC report found that deaths from opioid overdoses reached a record high in 2014. So, what are safe prescribing practices for opioids? Opioids and muscle relaxants do not provide additional pain relief for patients with acute low back pain who are on NSAIDs, according to a new study. The FDA issued a warning that pain […]
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