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The FDA has approved label changes for the use of general anesthesia and sedation drugs in young children, given warnings issued in late 2016 about the potential adverse effects on brain development with lengthy or repeated use. The label changes are as follows: A new warning states that exposure for prolonged periods or during multiple […]
Read MoreThe FDA has approved abaloparatide (marketed as Tymlos) for the treatment of postmenopausal women with osteoporosis who are at high risk for fracture — that is, those who have had a prior osteoporotic fracture, have multiple fracture risk factors, or have failed or cannot tolerate other osteoporosis therapies. The osteoanabolic agent is a synthetic analog […]
Read MoreEdited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM Spinal manipulation improves pain and function in adults with acute low back pain, although the effects are “clinically modest,” according to the authors of a JAMA meta-analysis. The analysis included 26 randomized controlled trials comparing spinal manipulation with sham or alternative treatments (e.g., physical therapy) […]
Read MoreAuthors: Abdullah Sulieman Terkawi, M.D. et al Anesthesiology 5 2017, Vol.126, 923-937 Background: Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic […]
Read MoreAuthors: Alexander Zarbock, M.D. et Anesthesiology 5 2017, Vol.126, 787-798. Background: In a multicenter, randomized trial, the authors enrolled patients at high-risk for acute kidney injury as identified by a Cleveland Clinic Foundation score of 6 or more. The authors enrolled 240 patients at four hospitals and randomized them to remote ischemic preconditioning or control. The authors […]
Read MoreAuthor: David H. Chestnut, M.D. Anesthesiology 5 2017, Vol.126, 780-786 Many observers have concluded that we have a crisis of professionalism in the practice of medicine. In this essay, the author identifies and discusses personal attributes and commitments important in the development and maintenance of physician professionalism: humility, servant leadership, self-awareness, kindness, altruism, attention to personal […]
Read MoreASA Monitor 04 2017, Vol.81, 56. A 67-year-old woman with no significant past medical history presents to the emergency department with dyspnea. Her electrocardiogram shows atrial flutter with a ventricular rate of 150 beats/minute. Which of the following would be most effective for pharmacologic cardioversion to sinus rhythm in this patient? Atrial flutter is a right-sided atrial re-entrant […]
Read MoreASA Monitor 04 2017, Vol.81, 46-47. You are in the process of placing a nontunneled central venous catheter (CVC) in an adult intensive care unit (ICU) patient. Based on the findings of a recent study, which of the following associations between CVC locations and adverse outcomes is mostlikely true? The use of CVCs has been associated with […]
Read MoreAuthors: Thomas R. MIller, Ph.D., M.B.A. et al ASA Monitor 04 2017, Vol.81, 10-12. How many anesthesia professionals will be providing patient care in 20 years? How many people will need procedures requiring anesthesia by that time? These may seem like questions best reserved for a crystal ball, but they are questions commonly asked among economists and […]
Read MoreBy Julie A. Schilling and McKenzie C. Ferguson, PharmD, BCPS Question: When prescribing duloxetine, what are the recommendations for monitoring liver function tests? Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that also exhibits weak inhibition of dopamine. It is approved by the Food and Drug Administration for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), […]
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