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The goal of any perioperative protocol is to improve patient outcomes after surgery. In colorectal surgery, however, there is minimal evidence to support traditional perioperative practices, such as bowel preparation and fasting before surgery. In the mid-1990s, this gap in understanding prompted a group of surgeons, led by Henrik Kehlet, MD, PhD, from Copenhagen, to […]
Read MoreHospital CEOs should focus less on talking about an organization’s cultureand more on the elements that make up a hospital’s culture, such as mindset, methods, strategies and structures, former physician John Kenagy, M.D., founder of Kenagy & Associates. Health system leaders must develop adaptive concepts that support and foster a culture that can go with […]
Read MoreAuthors: Pugh ME et al., Chest 2014 Jul 146:159 Left heart disease was a more likely cause of pulmonary hypertension in an older population. Pulmonary hypertension is being diagnosed in a growing number of older adults, but whether this trend is due to pulmonary arterial hypertension (PAH; pulmonary hypertension not secondary to left heart disease […]
Read MoreThe US Food and Drug Administration (FDA) has approved naloxegol (Movantik, AstraZeneca Pharmaceuticals), a peripherally acting opioid receptor antagonist, for the treatment of opioid-induced constipation (OIC) in adults with chronic noncancer pain. OIC is a common adverse effect of opioid use. An estimated 40% to 80% of patients receiving long-term opioid therapy experience OIC, which […]
Read MoreSpinal manipulation therapy plus home exercises is more effective than home exercises alone for treating back-related leg pain, according to a study in the Annals of Internal Medicine. Nearly 200 patients with subacute or chronic back-related leg pain were randomized to either spinal manipulation plus home exercises and advice or home exercises and advice alone […]
Read MoreAuthors: Dodick DW et al., Lancet Neurol 2014 Sep 13:885 A phase II study of a monoclonal antibody shows great promise for the first specific migraine-prevention therapy. Calcitonin gene-related peptide (CGRP) has been a long-standing therapeutic target of interest in migraine. Small-molecule CGRP receptor antagonists demonstrated effectiveness for the treatment of acute migraine attacks, but […]
Read MorePublished in J Neurosurg Anesthesiol. 2014 Oct;26(4):369-76 Authors: Davis N et al Abstract The effect of anesthetic technique on postoperative outcomes remains in question. This systematic review compares the role of regional versus general anesthesia, with a particular focus on postoperative cognitive function. Potentially relevant articles were identified by searching publicly available computerized databases for […]
Read MorePublished in J Neurosurg Anesthesiol. 2014 Aug 20 Authors: Hertle DN et al BACKGROUND: Disturbed brain metabolism is a signature of primary damage and/or precipitates secondary injury processes after severe brain injury. Sedatives and analgesics target electrophysiological functioning and are as such well-known modulators of brain energy metabolism. Still unclear, however, is how sedatives impact […]
Read MoreAuthors: Gialdini G et al., JAMA 2014 Aug 13; 312:616 Usually considered secondary to the stress of surgery, perioperative AF was associated with elevated risk for ischemic stroke 1 year later. Perioperative atrial fibrillation (AF) is common in cardiac surgery and is also seen in noncardiac surgery. Because AF is thought to be secondary to […]
Read MoreWorking alongside difficult people can be hard enough. But managing someone with whom you have a personality clash can cause major tension. Experienced managers know how to separate emotions from the work at hand when dealing with employees. Rather than dwelling on an employee’s negative personality traits, smart managers focus on tasks, projects and results. […]
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