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Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM Spinal manipulation improves pain and function in adults with acute low back pain, although the effects are “clinically modest,” according to the authors of a JAMA meta-analysis. The analysis included 26 randomized controlled trials comparing spinal manipulation with sham or alternative treatments (e.g., physical therapy) […]
Read MoreAuthors: Abdullah Sulieman Terkawi, M.D. et al Anesthesiology 5 2017, Vol.126, 923-937 Background: Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic […]
Read MoreAuthors: Alexander Zarbock, M.D. et Anesthesiology 5 2017, Vol.126, 787-798. Background: In a multicenter, randomized trial, the authors enrolled patients at high-risk for acute kidney injury as identified by a Cleveland Clinic Foundation score of 6 or more. The authors enrolled 240 patients at four hospitals and randomized them to remote ischemic preconditioning or control. The authors […]
Read MoreAuthor: David H. Chestnut, M.D. Anesthesiology 5 2017, Vol.126, 780-786 Many observers have concluded that we have a crisis of professionalism in the practice of medicine. In this essay, the author identifies and discusses personal attributes and commitments important in the development and maintenance of physician professionalism: humility, servant leadership, self-awareness, kindness, altruism, attention to personal […]
Read MoreASA Monitor 04 2017, Vol.81, 56. A 67-year-old woman with no significant past medical history presents to the emergency department with dyspnea. Her electrocardiogram shows atrial flutter with a ventricular rate of 150 beats/minute. Which of the following would be most effective for pharmacologic cardioversion to sinus rhythm in this patient? Atrial flutter is a right-sided atrial re-entrant […]
Read MoreASA Monitor 04 2017, Vol.81, 46-47. You are in the process of placing a nontunneled central venous catheter (CVC) in an adult intensive care unit (ICU) patient. Based on the findings of a recent study, which of the following associations between CVC locations and adverse outcomes is mostlikely true? The use of CVCs has been associated with […]
Read MoreAuthors: Thomas R. MIller, Ph.D., M.B.A. et al ASA Monitor 04 2017, Vol.81, 10-12. How many anesthesia professionals will be providing patient care in 20 years? How many people will need procedures requiring anesthesia by that time? These may seem like questions best reserved for a crystal ball, but they are questions commonly asked among economists and […]
Read MoreBy Julie A. Schilling and McKenzie C. Ferguson, PharmD, BCPS Question: When prescribing duloxetine, what are the recommendations for monitoring liver function tests? Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that also exhibits weak inhibition of dopamine. It is approved by the Food and Drug Administration for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), […]
Read MoreAUTHORS: Oras J, Redfors B et al Acta Anaesthesiologica Scandinavica (Jan 2017) BACKGROUND Takotsubo syndrome (TS) is an acute cardiac condition with a substantial mortality for which no specific treatment is available. We have previously shown that isoflurane attenuates the development of left ventricular (LV) dysfunction in an experimental TS-model. We compared the effects of […]
Read MoreNationwide efforts to make health care safer are paying off, according to a report released by the Department of Health and Human Services (HHS). Thanks, in part, to provisions of the Affordable Care Act (ACA), approximately 125,000 fewer patients died due to hospital-acquired conditions (HACs), and more than $28 billion in health care costs were […]
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