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Uncategorized Published - 4 June, 2018    By - Dr Clemens
Anesthesia Care Team Composition and Surgical Outcomes

Authors: Eric C. Sun, M.D., Ph.D. et al   Anesthesiology published on May 29, 2018. Background: In the United States, anesthesia care can be provided by an anesthesia care team consisting of nonphysician providers (nurse anesthetists and anesthesiologist assistants) working under the supervision of a physician anesthesiologist. Nurse anesthetists may practice nationwide, whereas anesthesiologist assistants are restricted to […]

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Uncategorized Published - 4 June, 2018    By - Dr Clemens
Exercise Training Doesn’t Slow Progression of Cognitive Decline in People with Dementia

I wanted to share this with our readers because I am an old guy so this is important to at least me. Authors: Lamb SE et al.  BMJ 2018 May 16. Supervised exercise might improve physical fitness but doesn’t help cognition. Evidence is mixed on whether physical exercise improves cognitive impairment. In this trial, U.K. investigators […]

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Uncategorized Published - 1 June, 2018    By - Dr Clemens
Cardiac Output Measurements Based on the Pulse Wave Transit Time and Thoracic Impedance Exhibit Limited Agreement With Thermodilution Method During Orthotopic Liver Transplantation

AUTHORS: Magliocca, Aurora, MD et al Anesthesia & Analgesia: January 2018 – Volume 126 – Issue 1 – p 85–92 BACKGROUND: Orthotopic liver transplantation (OLT) is characterized by significant intraoperative hemodynamic variability. Accurate and real-time cardiac output (CO) monitoring aids clinical decision making during OLT. The purpose of this study is to compare accuracy, precision, and trending […]

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Uncategorized Published - 1 June, 2018    By - Dr Clemens
nfluence of Depth of Hypnosis on Pupillary Reactivity to a Standardized Tetanic Stimulus in Patients Under Propofol-Remifentanil Target–Controlled Infusion: A Crossover Randomized Pilot Study

AUTHORS: Sabourdin, Nada, MD et al Anesthesia & Analgesia: January 2018 – Volume 126 – Issue 1 – p 70–77 BACKGROUND: Pupillometry allows the measurement of pupillary diameter variations in response to nociceptive stimuli. This technique has been used to monitor the balance between analgesia and nociception. Under general anesthesia, the amplitude of pupillary dilation is related […]

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Uncategorized Published - 1 June, 2018    By - Dr Clemens
Type 2 Perioperative Myocardial Infarction: Can We Close Pandora’s Box?

Author: Martin J. London, M.D., F.A.S.E. Anesthesiology 6 2018, Vol.128, 1055-1059. “…what constitutes [perioperative] myocardial infarction, its subtypes, and treatment strategies[?]” In this issue of the Anesthesiology, Helwani et al.1  address the etiology, classification, and prognosis of perioperative myocardial infarction (MI), a subject of investigation for more than 75 yr now. A unique feature of their study is […]

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Uncategorized Published - 1 June, 2018    By - Dr Clemens
Association of Polypharmacy with Survival, Complications, and Healthcare Resource Use after Elective Noncardiac Surgery: A Population-based Cohort Study

Authors: Daniel I. McIsaac, M.D., M.P.H., F.R.C.P.C. et al  Anesthesiology 6 2018, Vol.128, 1140-1150. Background: Polypharmacy is increasingly prevalent in older patients and is associated with adverse events among medical patients. The impact of polypharmacy on outcomes after elective surgery is poorly described. The authors’ objective was to measure the association of polypharmacy with survival, complications, and […]

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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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