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The American College of Chest Physicians has issued new guidelines on antithrombotic therapy for venous thromboembolism (VTE), including guidance on use of non-vitamin K antagonist oral anticoagulants. Among the recently changed or added recommendations, published in Chest: For patients without cancer who have deep vein thrombosis (DVT) of the leg or pulmonary embolism (PE), the guidelines […]
Read MoreCarol Peckham. Malpractice and Medicine: Who Gets Sued and Why? Medscape. Dec 08, The Scope of the Malpractice Problem Medscape surveyed almost 4000 primary care physicians and selected specialists to find out if and why they were sued and how the lawsuit affected their career and patient care decisions. Fifty-nine percent of respondents to the Medscape survey have been named in […]
Read MoreTzimas et al Br J Anaesth. 2015;115(2):194-202. Abstract Clinicians inevitably encounter patients who meet the diagnostic criteria for the metabolic syndrome (MetS); these criteria include central obesity, hypertension, atherogenic dyslipidaemia, and hyperglycaemia. Regardless of the variations in its definition, MetS may be associated with adverse outcomes in patients undergoing both cardiac and non-cardiac surgery. There is […]
Read MoreAnesthesia & Analgesia: December 2015 Sitsen, Elske MD et al BACKGROUND: Neuraxial blockade reduces the dose requirements of sedative agents. It is unclear whether neuraxial blockade affects the pharmacokinetics and/or the pharmacodynamics of IV hypnotics. We therefore studied the influence of epidural blockade on the pharmacokinetics of propofol in patients scheduled for general surgery. METHODS: […]
Read MoreAnesthesia & Analgesia: December 2015 Blanié, Antonia MD et al BACKGROUND: In this prospective observational study, we compared changes in cardiac index (CI) during fluid challenge using photoplethysmography (PPG; Nexfin(TM)) (CIPPG) versus esophageal Doppler (ED) (CIED) in major noncardiac surgery patients. METHODS: Measurements were obtained when the attending anesthesiologist decided to perform a fluid challenge. […]
Read MoreAnesthesia & Analgesia: December 2015 Whitener, George MD et al BACKGROUND: Current guidelines define severe aortic valve stenosis (AS) as an aortic valve area (AVA) <=1.0 cm2 by the continuity equation and mean gradient ([DELTA]Pm) >= 40 mm Hg. However, these measurements can be discordant when classifying AS severity. Approximately one-third of patients with normal […]
Read MoreOlder women appear to be at higher risk than older men for deterioration in neurologic and cognitive functioning as well as ventricular brain volumes following the administration of general anesthesia and surgery. That was the conclusion of a study that tracked cognitive aging in more than 500 elderly people over time. Elderly women and men […]
Read MoreAziz MF et al., Anesth Analg 2015 Nov In patients with predicted difficult airways intubated in the operating room, the GlideScope had a higher first-attempt intubation success rate than the C-MAC D-Blade. Video laryngoscopy (VL) improves intubation success in patients with predicted difficult airways primarily by ensuring glottic visualization. While VL with acute-angled devices has been compared […]
Read MoreAnesthesia & Analgesia: December 2015 Anastasian, Zirka H. MD et al BACKGROUND: Factors including ASA physical status, blood loss, and case length have been described as correlating with the decision to delay tracheal extubation after specific surgical procedures. In this retrospective study, we investigated whether handoffs by anesthesia attendings were associated with delayed extubation […]
Read MoreEur J Anaesthesiol. 2015 Nov;32(11):764-70 Sauter AR et al BACKGROUND: The Shamrock technique is a new method for ultrasound-guided lumbar plexus blockade. Data on the optimal local anaesthetic dose are not available. OBJECTIVE: The objective of this study is to estimate the effective dose of ropivacaine 0.5% for a Shamrock lumbar plexus block. DESIGN: A prospective […]
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