Author: Dr Clemens

Uncategorized Published - 1 June, 2018    By - Dr Clemens
FDA Approves First Non-Opioid Drug to Treat Opioid Withdrawal

The FDA has approved Lucemyra (lofexidine hydrochloride), a non-opioid, to help lessen the symptoms of opioid withdrawal in adults. Oral lofexidine, a selective alpha 2-adrenergic receptor agonist that inhibits the release of norepinephrine, is approved for up to 14 days of treatment. The FDA notes that it doesn’t treat opioid use disorder, but it can […]

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Uncategorized Published - 31 May, 2018    By - Dr Clemens
Liposomal Bupivacaine Does Not Reduce Inpatient Opioid Prescription or Related Complications after Knee Arthroplasty: A Database Analysis

AUTHORS: Lukas Pichler, M.D. et al  Anesthesiology published on May 21, 2018. Background: Although some trials suggest benefits of liposomal bupivacaine, data on real-world use and effectiveness is lacking. This study analyzed the impact of liposomal bupivacaine use (regardless of administration route) on inpatient opioid prescription, resource utilization, and opioid-related complications among patients undergoing total knee arthroplasties […]

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Uncategorized Published - 31 May, 2018    By - Dr Clemens
In Noncardiac Surgery, Clinical Frailty Scale More Practical Perioperative Instrument for Predicting Disabilities

When it comes to predicting disabilities in frail patients after elective noncardiac surgery, the Clinical Frailty Scale (CFS) and the modified Fried Index (mFI) prove generally comparable. Where the two tools diverge, however, is in their ease and speed of administration, which seems to favor the CFS, according to researchers at the University of Ottawa. […]

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Uncategorized Published - 31 May, 2018    By - Dr Clemens
Changing Trend in Indications for Liver Transplantation in the U.S.

Authors: Cholankeril G et al  Clin Gastroenterol Hepatol 2017 Nov  Alcohol-related liver disease has surpassed HCV infection as the most common indication for liver transplantation. With the advent of direct-acting antiviral therapies for hepatitis C virus (HCV) infection, the frequency of liver transplantation (LT) performed because of HCV infection is expected to decline. A recent study […]

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Uncategorized Published - 31 May, 2018    By - Dr Clemens
Should Hip Fractures Be Repaired Surgically in Nursing Home Residents with Dementia?

AUTHORS: Berry SD et al.  JAMA Intern Med 2018 May 7. A retrospective study suggests mortality and morbidity might be lower with surgical repair. A common dilemma is whether to repair hip fractures in nursing home patients with severe dementia. To explore this issue, investigators used a Medicare dataset to identify 3083 nursing home patients (mean […]

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Uncategorized Published - 31 May, 2018    By - Dr Clemens
Inhaled nitric oxide may not improve survival of preterm infants

Authors: Ellsworth KR, et al. JAMA Pediatr. 2018; Preterm infants born younger than 29 weeks’ gestational age who were treated for pulmonary hypoplasia with inhaled nitric oxide did not have an increased chance of in-hospital survival, according to findings published in JAMA Pediatrics. “Because blood vessel growth in the lung parallels airway development, pulmonary hypoplasia is often […]

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Uncategorized Published - 30 May, 2018    By - Dr Clemens
Hyperinsulinemic Normoglycemia during Cardiac Surgery Reduces a Composite of 30-day Mortality and Serious In-hospital Complications: A Randomized Clinical Trial

AUTHORS: Andra E. Duncan, M.D. et al     Anesthesiology 6 2018, Vol.128, 1125-1139. Background: Hyperinsulinemic normoglycemia augments myocardial glucose uptake and utilization. We tested the hypothesis that hyperinsulinemic normoglycemia reduces 30-day mortality and morbidity after cardiac surgery. Methods: This dual-center, parallel-group, superiority trial randomized cardiac surgical patients between August 2007 and March 2015 at the Cleveland Clinic, Cleveland, […]

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Uncategorized Published - 30 May, 2018    By - Dr Clemens
Positive End-expiratory Pressure Alone Minimizes Atelectasis Formation in Nonabdominal Surgery: A Randomized Controlled Trial

AUTHORS: Erland Östberg, M.D. et al      Anesthesiology 6 2018, Vol.128, 1117-1124. Background: Various methods for protective ventilation are increasingly being recommended for patients undergoing general anesthesia. However, the importance of each individual component is still unclear. In particular, the perioperative use of positive end-expiratory pressure (PEEP) remains controversial. The authors tested the hypothesis that PEEP […]

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Uncategorized Published - 30 May, 2018    By - Dr Clemens
Etiology of Acute Coronary Syndrome after Noncardiac Surgery

AUTHORS: Mohammad A. Helwani, M.D., M.S.P.H. et al     Anesthesiology 6 2018, Vol.128, 1084-1091. Background: The objective of this investigation was to determine the etiology of perioperative acute coronary syndrome with a particular emphasis on thrombosis versus demand ischemia. Methods: In this retrospective cohort study, adult patients were identified who underwent coronary angiography for acute coronary syndrome within 30 days […]

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Uncategorized Published - 30 May, 2018    By - Dr Clemens
Time Out — Charting a Path for Improving Performance Measurement

Authors: Catherine H. MacLean, M.D., Ph.D. et al This article was published on April 18, 2018, at NEJM.org. Performance measurement in the U.S. health care system has expanded dramatically over the past 30 years. The National Quality Measures Clearinghouse now lists more than 2500 performance measures. These measures are used in various quality-reporting, accountability, and payment […]

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