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President Obama’s Administration has introduced some major expansions to the 2016 fiscal budget to help aid states in preventing opioid deaths. Reviewed by Forest Tennant, MD, DrPH As most physicians are aware, overdoses from prescription opioids have risen at an alarming rate over the last few decades, with more people dying from opioids than from heroin and cocaine […]
Read MoreWith a new push to combat the opioid abuse epidemic, the Substance Abuse and Mental Health Services Administration (SAMHSA) has launched a new smartphone app providing essential resources for health care providers. The recent push to get more patients access to medication assisted treatment (MAT) for opioid addiction, and more doctors trained to provide it, […]
Read MoreFor the first time, scientists say they have found a region in the brain responsible for the ”placebo effect” in pain relief; they say the discovery has the potential to improve clinical trial accuracy and to personalize pain treatments. Interview with Marwan Baliki, PhD For the first time, researchers say they have identified the ”sweet […]
Read MoreAuthors: Ferguson ND., JAMA 2016 Oct 18; 316:1553 Outcomes were worse with a conventional high-oxygenation goal than with a conservative moderate-oxygenation goal. Increasingly, excess oxygen administration is recognized as a risk factor for adverse outcomes when used perioperatively (NEJM JW Infect Dis Nov 2009 and JAMA 2009; 302:1543) or after myocardial infarction (NEJM JW Hosp Med Aug 2015 and Circulation2015; 131:2143). But […]
Read MoreAuthors: Göran Hedenstierna, M.D., Ph.D. et al Anesthesiology 12/ 2016, Vol.125, 1079-1082. SEVERAL clinical trials on protective ventilation during anesthesia and postoperative pulmonary complications have been performed during the past years and assumed to be suitable as guidelines for clinical treatment.1–8 Comprehensive reviews and meta-analysis have also been performed.9,10 Why then do these studies differ in their recommendations? […]
Read MoreAuthors: Tyler J. Wellman, Ph.D. et al Commentary: Early Regional Inflammation: The Seeds of Lung Injury Anesthesiology 11 2016, Vol.125, 992-1004. Background: Acute respiratory distress syndrome (ARDS) is an inflammatory condition comprising diffuse lung edema and alveolar damage. ARDS frequently results from regional injury mechanisms. However, it is unknown whether detectable inflammation precedes lung edema and opacification and […]
Read MoreAuthor: Jonathan V. Roth, M.D. Anesthesiology 12 2016, Vol.125, 1253-1254. The results of the study of management of one-lung ventilation by Blank et al. suggest that adequate positive end-expiratory pressure (PEEP) is an important factor in reducing pulmonary complications. Blank et al.1 provide an excellent discussion of the mechanical mechanisms and implications. I suggest an alternative or additional possible explanation […]
Read MoreAuthors: Gaspard Montandon, Ph.D. et al Anesthesiology 11 2016, Vol.125, 889-903. Background: Opioid analgesia is an essential component of perioperative care, but effective analgesia can be limited by excessive sedation and respiratory depression. The cortical signatures associated with sedation by opioids and the relationship between changes in cortical activity and respiratory function are not well understood. The […]
Read MoreAuthors: Vafi Salmasi, M.D. et al Anesthesiology published on November 3, 2016. Background: How best to characterize intraoperative hypotension remains unclear. Thus, the authors assessed the relationship between myocardial and kidney injury and intraoperative absolute (intraoperative mean arterial pressure [MAP]) and relative (reduction from preoperative pressure) MAP thresholds. Methods: The authors characterized hypotension by the lowest MAP […]
Read MoreASA Monitor 11 2016, Vol.80, 50-51. Review of unusual patient care experiences is a cornerstone of medical education. Each month, the AQI-AIRS Steering Committee abstracts a patient history submitted to the Anesthesia Incident Reporting System (AIRS) and authors a discussion of the safety and human factors challenges involved. Real-life case histories often include multiple clinical decisions, […]
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