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Authors: Hendriksen JMT et al., BMJ 2015 Sep 8; 351:h4438 In the primary care setting, Wells and Geneva rules all performed well. How accurate are prediction rules, combined with point-of-care D-dimer testing, for ruling out pulmonary embolism (PE) in the primary care setting? In a systematic review followed by a validation study, researchers assessed five rules and specific […]
Read MoreAuthors: Wechsler ME et al., JAMA 2015 Oct 27; 314:1720 Tiotropium is not inferior to long-acting β-agonists for add-on asthma therapy. National asthma guidelines recommend long-acting β-agonists (LABAs) for patients whose asthma is not controlled by low-dose inhaled corticosteroids (ICS; J Allergy Clin Immunol 2007; 120:5 Suppl:S94); however, LABAs might be associated with risk for severe asthma exacerbations. […]
Read MoreAuthors: Gill JC et al., Blood 2015 Oct 22; 126:2038 Outcomes were excellent in 96.9% of bleeds in patients with severe disease. Patients with severe von Willebrand disease (VWD) have persistent, recurrent episodes of mucosal bleeding, menorrhagia, and bleeding with surgery or trauma. Treatment with plasma-derived von Willebrand factor (VWF) concentrates controls bleeding but exposes patients to […]
Read MoreAuthors: You-Ten KE et al., Anaesthesia 2015 Nov 70:1230 In laboring at-term patients, palpation of the cricothyroid membrane was less accurate in obese than in nonobese patients, whereas ultrasound identified the cricothyroid membrane in all patients. Obesity is a common marker of airway difficulty and may make a “can’t intubate, can’t oxygenate” scenario (and the need for […]
Read MoreAuthors: Felix Kork, MD et al Anesthesiology 12 2015, Vol.123, 1301-1311 Background: Surgical patients frequently experience postoperative increases in creatinine levels. The authors hypothesized that even small increases in postoperative creatinine levels are associated with adverse outcomes. Methods: The authors examined the association of postoperative changes from preoperative baseline creatinine with all-cause in-hospital mortality and hospital length of […]
Read MoreAuthors: Oivind Jans, MD. PhD et al Anesthesiology 12 2015, Vol.123, 1292-1300 Background: Early postoperative mobilization is essential for rapid recovery but may be impaired by orthostatic intolerance (OI) and orthostatic hypotension (OH), which are highly prevalent after major surgery. Pathogenic mechanisms include an insufficient postoperative vasopressor response. The oral α-1 agonist midodrine hydrochloride increases vascular resistance, […]
Read MoreAuthors: Elizabeth L. Whitlock, MD et al Anesthesiology 12 2015, Vol.123, 1312-1321. Background: The National Anesthesia Clinical Outcomes Registry collects demographic and outcome data from anesthesia cases, with the goal of improving safety and quality across the specialty. The authors present a preliminary analysis of the National Anesthesia Clinical Outcomes Registry database focusing on the rates of […]
Read MoreAuthors: Rasmus Vestergaard Juul, M.SC et al Anesthesiology 12 2015, Vol.123, 1411-1419 Background: Reduction in consumption of opioid rescue medication is often used as an endpoint when investigating analgesic efficacy of drugs by adjunct treatment, but appropriate methods are needed to analyze analgesic consumption in time. Repeated time-to-event (RTTE) modeling is proposed as a way to describe analgesic […]
Read MoreAuthors: Neumar RW et al., Circulation 2015 Nov 3; 132:S315 Push hard and fast — but not too hard or too fast! Sponsoring Organization: American Heart Association (AHA) Target Population: Lay public, healthcare providers Background and Objective The AHA has released an evidence-based update to its 2010 guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care. Key Points Adult […]
Read MoreAuthor: Robbins MS et al., Neurology 2015 Sep 22; 85:1024 New findings from a hospital-based retrospective study suggest some differences in primary versus secondary headache characteristics in this population. In this retrospective chart review, researchers describe demographics, comorbidities, and clinical features of acute headache in pregnant women who received a neurological consultation for headache at one hospital […]
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