MB's Articles of Interest - April 2002

ARTICLE TITLE: Triage of patients with chest pain in the emergency department: a comparative study of physicians' decisions
ARTICLE SOURCE: Am J Med (United States), Feb 1 2002, 112(2) p95-103
AUTHOR(S): Reilly BM; Evans AT; Schaider JJ; Wang Y
AUTHOR'S ADDRESS: Departments of Medicine and Emergency Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois 60612, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: In simulated cases, physicians' triage decisions varied widely and their predictions of patient outcomes differed markedly from that of the validated prediction rule, suggesting that use of the prediction rule in the emergency department could improve physicians' decisions and patients' outcomes.

ARTICLE TITLE: Prognosis of patients who develop acute renal failure during the first 24 hours of cardiogenic shock after myocardial infarction
ARTICLE SOURCE: Am J Med (United States), Feb 1 2002, 112(2) p115-9
AUTHOR(S): Koreny M; Karth GD; Geppert A; Neunteufl T; Priglinger U; Heinz G; Siostrzonek P
AUTHOR'S ADDRESS: Cardiovascular Intensive Care Unit, Department of Cardiology, University of Vienna, Vienna, Austria.
PUBLICATION TYPE:
Journal Article
ABSTRACT: PURPOSE: Acute renal failure has important prognostic implications in critically ill patients, but the effects of acute renal failure on in-hospital mortality in the subset of patients with cardiogenic shock are not known. SUBJECTS AND METHODS: All consecutive patients who presented with acute coronary syndrome at our cardiovascular intensive care unit from 1993 to 2000 and who were in cardiogenic shock were enrolled. Acute renal failure was defined as a urine volume < 20 mL/h associated with an increase in serum creatinine level > or = 0.5 mg/dL or > 50% above the baseline value. RESULTS: There were 118 patients (83 men [70%]; mean [+/- SD] age, 66 +/- 10 years), 39 (33%) of whom developed acute renal failure within 24 hours after the onset of shock. In-hospital mortality was 87% (34/39) in patients with acute renal failure and 53% (42/79) in patients without acute renal failure (odds ratio [OR] = 6.0; 95% confidence interval [CI]: 2.1 to 17; P < 0.001). Other significant univariate predictors of mortality included the peak serum lactate level, epinephrine dose, and the maximum serum creatinine level. Multivariate logistic regression analysis identified acute renal failure as the only independent predictor of mortality. CONCLUSION: Acute renal failure was common in patients with cardiogenic shock and strongly associated with in-hospital mortality.
MB: On their criteria that should have applied to me but they did exclude those who had cardiopulmonary resuscitation.

ARTICLE TITLE: Open heart surgery in the elderly: results from a consecutive series of 100 patients aged 85 years or older
ARTICLE SOURCE: Am J Med (United States), Feb 2002, 112(2) p143-7
AUTHOR(S): Rosengart TK; Finnin EB; Kim DY; Samy SA; Tanhehco Y; Ko W; Lang SJ; Krieger KH; Isom OW
AUTHOR'S ADDRESS: Division of Cardiothoracic Surgery (TKR, EBF, DYK), Department of Surgery, Evanston Northwestern Healthcare-Northwestern University Medical School, Evanston, Illinois, USA.
PUBLICATION TYPE:

ARTICLE TITLE: A case of triplicate publication.
COMMENTS: Comment In: Comment In: RefSource:Am J Med. 2002 Jan; 112(1):77
ARTICLE SOURCE: Am J Med (United States), Jan 2002, 112(1) p78-9
AUTHOR(S): Weber DJ; Rutala WA
MAJOR SUBJECT HEADING(S): Duplicate Publication
PUBLICATION TYPE: Letter

ARTICLE TITLE: Triplicate publication, not an epidemic.
COMMENTS: Comment On: Comment On: RefSource:Am J Med. 2002 Jan; 112(1):78-9
ARTICLE SOURCE: Am J Med (United States), Jan 2002, 112(1) p77
AUTHOR(S): Goldman L
PUBLICATION TYPE: Comment; Editorial
MB: I thought that meant that there was not an epidemic of triplicate publications but they are referring to the infection reported in the paper.

ARTICLE TITLE: Re: Routine perioperative pulmonary artery catheterization has no effect on rate of complications in vascular surgery: a meta-analysis.
ARTICLE SOURCE: Am Surg (United States), Feb 2002, 68(2) p214-5
AUTHOR(S): Lyons WS
PUBLICATION TYPE: Letter

ARTICLE TITLE: The importance of postdischarge telephone follow-up for hospitalists: a view from the trenches.
ARTICLE SOURCE: Am J Med (United States), Dec 21 2001, 111(9B) p43S-44S
AUTHOR(S): Nelson JR
AUTHOR'S ADDRESS: Overlake Hospital Medical Center, Bellevue, Washington 98004, USA.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
ABSTRACT: Hospitalist practice highlights the need for effective communication between doctors that share the care of a patient, and between doctors and patients. Telephone contact with patients after hospital discharge can enhance adherence, inform the hospitalist about the results of treatment or of adverse outcomes, and allow the hospitalist to receive feedback from the patient and family.
MB: I had a complaint made about me because I did that.

ARTICLE TITLE: The impact of follow-up telephone calls to patients after hospitalization.
ARTICLE SOURCE: Am J Med (United States), Dec 21 2001, 111(9B) p26S-30S
AUTHOR(S): Dudas V; Bookwalter T; Kerr KM; Pantilat SZ
AUTHOR'S ADDRESS: Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco 94143-0903, USA.
PUBLICATION TYPE: Journal Article
A follow-up phone call by a pharmacist involved in the hospital care of patients was associated with increased patient satisfaction, resolution of medication-related problems, and fewer return visits to the emergency department.

ARTICLE TITLE: Protecting professors from the burden of teaching.
ARTICLE SOURCE: Am J Med (United States), Dec 15 2001, 111(9) p736-7
AUTHOR(S): Glew RH; Anderson W
PUBLICATION TYPE: Letter
MB: The applicants for tenured positions did not seem to want to teach.

ARTICLE TITLE: Esmolol and anesthetic requirement for loss of responsiveness during propofol anesthesia.
ARTICLE SOURCE: Anesth Analg (United States), Jan 2002, 94(1) p112-6, table of contents
AUTHOR(S): Orme R; Leslie K; Umranikar A; Ugoni A
AUTHOR'S ADDRESS: Department of Anaesthesia, Ballarat Base Hospital, Ballarat, Victoria, Australia.
PUBLICATION TYPE´Clinical Trial; Journal Article; Randomized Controlled Trial
IMPLICATIONS: There is no evidence to suggest that esmolol, an ultra-short-acting cardioselective beta-blocker, affects anesthetic requirement for loss of responsiveness during propofol anesthesia.
MB: I suppose it might if they used the pulse rate as one of the criteria for deciding to alter the propfol infusion rate. They were looking at response in relation of blood propofol level

ARTICLE TITLE: Epidural hematoma after outpatient epidural anesthesia.
ARTICLE SOURCE: Anesth Analg (United States), Jan 2002, 94(1) p77-8, table of contents
AUTHOR(S): Gilbert A; Owens BD; Mulroy MF
AUTHOR'S ADDRESS: Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington 98111, USA.
PUBLICATION TYPE: Journal Article
ABSTRACT: IMPLICATIONS: Epidural hematoma is a rare complication of epidural anesthesia in healthy patients. Expedient diagnosis and treatment are essential to avoid permanent neurologic deficits. In an outpatient setting, patients should be instructed to communicate symptoms of severe back pain or weakness early.
MB: They will persist with this method and in out-patients.

ARTICLE TITLE: What are the most important risk factors for a patient's developing intraoperative hypothermia?
ARTICLE SOURCE: Anesth Analg (United States), Jan 2002, 94(1) p215-20, table of contents
AUTHOR(S): Macario A; Dexter F
AUTHOR'S ADDRESS: Department of Anesthesia, Stanford University, Stanford, California 94305-5640, USA. amaca@stanford.edu.
PUBLICATION TYPE: Journal Article
The risk factors identified to be most important can now be further evaluated in clinical trials to develop a multivariate predictive tool for calculating a patient's a priori risk for developing hypothermia. IMPLICATIONS: Surveys of clinicians and physician researchers identified what they consider to be the most important risk factors for perioperative hypothermia (e.g., neonates, a low ambient operating room temperature, burn patients, and general anesthesia with neuraxial anesthesia).
MB: I think most of those factors have already been documented in the literature.

ARTICLE TITLE: Human error: the persisting risk of blood transfusion: a report of five cases.
ARTICLE SOURCE: Anesth Analg (United States), Jan 2002, 94(1) p154-6, table of contents
AUTHOR(S): Krombach J; Kampe S; Gathof BS; Diefenbach C; Kasper SM
AUTHOR'S ADDRESS: Department of Anesthesiology, University of Cologne, Germany. krombach@netcologne.de.
PUBLICATION TYPE: Status: Completed
Journal Article
ABSTRACT: It is common experience that virus transmission, particularly transmission of the human immunodeficiency virus (HIV), is a principal concern of patients and physicians regarding blood transfusion (1). Many physicians are probably unaware that transfusion-transmitted HIV infection is approximately 50 to 100 times less likely to occur than transfusion error (2-4). This misconception may have been encouraged by the scarcity of reports on transfusion error relative to the tremendous public attention focused on HIV infection. We present five cases illustrating how anesthesiologists, intensivists, and emergency physicians are particularly vulnerable to the risk of administering blood to the wrong recipient. All five cases were collected during a 4-yr period. Transfused units of packed red cells totaled approximately 50,000 U during this period in our department. IMPLICATIONS: Human error leading to the transfusion of blood to an unintended recipient is a major source of transfusion-related fatalities. We report five cases that highlight some specific areas in which transfusion error is likely to occur.

ARTICLE TITLE: The use of a human patient simulator in the evaluation of and development of a remedial prescription for an anesthesiologist with lapsed medical skills.
ARTICLE SOURCE: Anesth Analg (United States), Jan 2002, 94(1) p149-53, table of contents
AUTHOR(S): Rosenblatt MA; Abrams KJ
AUTHOR'S ADDRESS: Department of Anesthesiology, The Mount Sinai School of Medicine, New York, New York 10029-6574, USA. meg.rosenblatt@mountsinai.org; Collective Name: New York State Society of Anesthesiologists, Inc; Collective Name: Committee on Continuing Medical Education and Remediation; Collective Name: Remediation Sub-Committee.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Postoperative analgesia: economics, resource use, and patient satisfaction in an urban teaching hospital.
ARTICLE SOURCE: Anesth Analg (United States), Jan 2002, 94(1) p130-7, table of contents
AUTHOR(S): Strassels SA; Chen C; Carr DB
AUTHOR'S ADDRESS: Department of Pharmacy, University of Washington, Seattle, Washington 98195, USA. scotts1@u.washington.edu.
PUBLICATION TYPE: Journal Article
IMPLICATIONS: Despite impressive relief with analgesics, postoperative pain interferes with patients' ability to sleep, walk, and participate in other activities. Medications used postoperatively account for a small portion of total costs. Satisfaction ratings alone are a poor indicator of pain control. These data can be used to help improve pain relief.

ARTICLE TITLE: Bispectral index values and spectral edge frequency at different stages of physiologic sleep.
ARTICLE SOURCE: Anesth Analg (United States), Jan 2002, 94(1) p125-9, table of contents
AUTHOR(S): Nieuwenhuijs D; Coleman EL; Douglas NJ; Drummond GB; Dahan A
AUTHOR'S ADDRESS: Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands. djfn@worldonline.nl.
PUBLICATION TYPE: Journal Article
IMPLICATIONS: Although computer processing of the electroencephalogram can provide an adequate index of depth of anesthesia, the same processing cannot reliably convey depth of natural sleep. At each sleep stage, the output signal has a wide range of possible values.
MB: I don't know how they can think that they can conclude that the device is reliable for depth of anesthesia

ARTICLE TITLE: The safety of immediate extubation after abdominal aortic surgery: a prospective, randomized trial.
ARTICLE SOURCE: Anesth Analg (United States), Dec 2001, 93(6) p1546-9, table of contents
AUTHOR(S): Cohen J; Loewinger J; Hutin K; Sulkes J; Zelikovski A; Singer P
AUTHOR'S ADDRESS: Department of General Intensive Care, Rabin Medical Center, Beilinson Campus, Petah Tikva, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
ABSTRACT: We performed this study to assess the safety of immediate extubation after elective abdominal aortic aneurysm surgery. Consecutive patients were prospectively randomized into two groups after surgery: Group 1 (n = 29) immediate extubation; and Group 2 (n = 21) delayed (at least 4 h) extubation. IMPLICATIONS: In this prospective randomized study, we compared the outcome of patients undergoing elective aortic abdominal surgery who either were extubated immediately after surgery or after 4 h of stabilization in the intensive care unit. No significant differences were found in the length of intensive care unit or hospital stay, or 28-day mortality between the 2 groups.
MB: I'd be surprised if they found a difference in that number of patients having decided to delay extubation until 4 hours. All AAAs were extubated immediately in my mainly vascular practice between 1961 & 1972. Enough ended up having to be ventilated after several days & some dies so we decided to institute prophylactic ventilation for a day or so. We have had no reason to regret this policy. At least one died when we did not. Few have open AAAs now. Endoluminal AAAs are not routinely ventilated.

ARTICLE TITLE: Long-duration low-flow sevoflurane and isoflurane effects on postoperative renal and hepatic function.
ARTICLE SOURCE: Anesth Analg (United States), Dec 2001, 93(6) p1511-20, table of contents
AUTHOR(S): Kharasch ED; Frink EJ; Artru A; Michalowski P; Rooke GA; Nogami W
AUTHOR'S ADDRESS: Department of Anesthesiology, University of Washington, Seattle, Washington 98195, USA. kharasch@u.washington.edu.
IMPLICATIONS: Postoperative renal function after long-duration low-flow sevoflurane (with Compound A exposures greater than those typically reported) and isoflurane anesthesia were not different, as assessed by serum creatinine, blood urea nitrogen, and urinary excretion of protein and glucose. This suggests that low-flow sevoflurane is as safe as low-flow isoflurane, even at long exposures.

ARTICLE TITLE: Errors during intraoperative cell salvage because of inappropriate wash solutions.
ARTICLE SOURCE: Anesth Analg (United States), Dec 2001, 93(6) p1483-5, table of contents
AUTHOR(S): Waters JH; Sprung J
AUTHOR'S ADDRESS: Department of General Anesthesiology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. watersj@cesmtp.ccf.org.
PUBLICATION TYPE: Journal Article
ABSTRACT: IMPLICATIONS: Two case reports illustrate errors that can occur during intraoperative red blood cell salvage and emphasize the need for standardized procedures and quality improvement processes for this intervention.

ARTICLE TITLE: The frequency of perioperative vision loss.
ARTICLE SOURCE: Anesth Analg (United States), Dec 2001, 93(6) p1417-21, table of contents
AUTHOR(S): Warner ME; Warner MA; Garrity JA; MacKenzie RA; Warner DO
AUTHOR'S ADDRESS: Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA. warner.mary@mayo.edu.
PUBLICATION TYPE: Journal Article
IMPLICATIONS: Vision loss and blindness after surgery and anesthesia is a very rare event. In this study, only one per 125,234 patients undergoing noncardiac surgery developed vision loss persisting for longer than 30 days.

ARTICLE TITLE: One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia.
COMMENTS: Comment In: Comment In: RefSource:Anesth Analg. 2001 Dec; 93(6):1367-9/PMID:11726407
ARTICLE SOURCE: Anesth Analg (United States), Dec 2001, 93(6) p1373-6, table of contents
AUTHOR(S): Callesen T; Bech K; Kehlet H
AUTHOR'S ADDRESS: Department of Surgical Gastroenterology, H:S Hvidovre University Hospital, Hvidovre, Denmark. callesen@rh.dk.
PUBLICATION TYPE: Journal Article
IMPLICATIONS: Inguinal hernia repair can be safely performed under unmonitored local anesthesia with infrequent postoperative morbidity and acceptable satisfaction, but intraoperative pain may be a problem.

ARTICLE TITLE: Optimizing anesthesia for inguinal herniorrhaphy: general, regional, or local anesthesia?
COMMENTS: Comment On: Comment On: RefSource:Anesth Analg. 2001 Dec; 93(6):1373-6, table of contents/PMID:11726409
ARTICLE SOURCE: Anesth Analg (United States), Dec 2001, 93(6) p1367-9
AUTHOR(S): Kehlet H; White PF
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Pretreatment before succinylcholine for outpatient anesthesia?
ARTICLE SOURCE: Anesth Analg (United States), Mar 2002, 94(3) p573-6
AUTHOR(S): Mencke T; Schreiber JU; Becker C; Bolte M; Fuchs-Buder T
AUTHOR'S ADDRESS: Department of Anesthesia and Critical Care Medicine, University of the Saarland, Saar, Germany.
PUBLICATION TYPE: Journal Article
ABSTRACT: IMPLICATIONS: This study demonstrated that pretreatment of succinylcholine with rocuronium failed to decrease the incidence or the severity of postoperative myalgia. However, in most patients, pretreatment was associated with muscle weakness before loss of consciousness. Thus, there is no convincing evidence supporting routine pretreatment with succinylcholine.

ARTICLE TITLE: Rapacuronium and the risk of bronchospasm in pediatric patients
ARTICLE SOURCE: Anesth Analg (United States), Mar 2002, 94(3) p488-93
AUTHOR(S): Rajchert DM; Pasquariello CA; Watcha MF; Schreiner MS
AUTHOR'S ADDRESS: Department of Anesthesiology & Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania.
PUBLICATION TYPE:
Journal Article
MB: It's taking some time for these articles to stop after withdrawal of the drug for this complication.

ARTICLE TITLE: Rapacuronium redux
ARTICLE SOURCE: Anesth Analg (United States), Mar 2002, 94(3) p483-4
AUTHOR(S): Schulman SR
AUTHOR'S ADDRESS: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
PUBLICATION TYPE Journal Article

ARTICLE TITLE: Venous air emboli occur during release of positive end-expiratory pressure and repositioning after sitting position surgery ARTICLE SOURCE: Anesth Analg (United States), Feb 2002, 94(2) p400-3
AUTHOR(S): Schmitt HJ; Hemmerling TM
AUTHOR'S ADDRESS: Department of Anesthesiology, University Erlangen-Nuremberg, Germany.
PUBLICATION TYPE:
Journal Article
IMPLICATIONS: This study shows that venous air embolism (VAE) occurs not only during surgery in the sitting position but also during positive end-expiratory pressure release and repositioning of the patient into the supine position. Continuous monitoring for VAE should be performed until the patient is returned to the supine position.
MB: I stopped them sitting people up during neurosurgery here in about 1970.

ARTICLE TITLE: Electrocardiographic electrodes provide the same results as expensive special sensors in the routine monitoring of anesthetic depth
ARTICLE SOURCE: Anesth Analg (United States), Feb 2002, 94(2) p369-71
AUTHOR(S): Hemmerling TM; Harvey P
AUTHOR'S ADDRESS: Department of Anesthesiology and Biomedical Department, Universite de Montreal, Quebec, Canada.
PUBLICATION TYPE:
Journal Article
IMPLICATIONS: The Bispectral Index (BIS) monitor adequately monitors depth of anesthesia. The routine use of this monitor has been hampered by the benefit-cost equation because only special expensive electrodes can be used. We examined the agreement of BIS values obtained by original sensor electrodes and commercial electrocardiogram (ECG) electrodes. These ECG electrodes can replace more expensive BIS sensors.

ARTICLE TITLE: Good news, bad news
ARTICLE SOURCE: Anesth Analg (United States), Feb 2002, 94(2) p239-40
AUTHOR(S): Eger EI
AUTHOR'S ADDRESS: Department of Anesthesia and Perioperative Care, University of California, San Francisco, California.
PUBLICATION TYPE: Journal Article
MB: About hepatitic antibodies in anaesthetists.

ARTICLE TITLE: Use of meperidine in patient-controlled analgesia and the development of a normeperidine toxic reaction.
ARTICLE SOURCE: Arch Surg (United States), Jan 2002, 137(1) p84-8
AUTHOR(S): Simopoulos TT; Smith HS; Peeters-Asdourian C; Stevens DS
AUTHOR'S ADDRESS: Department of Anesthesiology and Critical Care, Postoperative Pain Services, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA. tsimopou@caregroup.harvard.edu.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: We recommend 10 mg/kg per day as a maximum safe meperidine hydrochloride dose by an IV PCA device for no longer than 3 days. Daily patient evaluation is mandatory. Care must also be taken when using this dose to ensure the absence of renal dysfunction or enhanced hepatic metabolism of meperidine.

ARTICLE TITLE: Preoperative cardiac risk assessment: an updated approach.
ARTICLE SOURCE: Arch Surg (United States), Dec 2001, 136(12) p1370-6
AUTHOR(S): Romero L; de Virgilio C
AUTHOR'S ADDRESS: Department of Surgery, Harbor UCLA Medical Center, 1000 W Carson St, Torrance, CA 90509, USA.
PUBLICATION TYPE Journal Article; Review; Review, Tutorial
CONCLUSIONS: Most patients with high cardiac risk should proceed with coronary angiography. Patients with low cardiac risk can proceed to surgery without noninvasive testing. For intermediate-risk patients, consideration may be given to further stress testing prior to surgery; however, in most patients, proceeding to surgery with perioperative beta-blockade is an acceptable alternative.
MB: There are some better things in cardiac literature.

ARTICLE TITLE: Clinical practice. Lowering cardiac risk in noncardiac surgery.
ARTICLE SOURCE: N Engl J Med (United States), Dec 6 2001, 345(23) p1677-82
AUTHOR(S): Fleisher LA; Eagle KA
AUTHOR'S ADDRESS: Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, USA.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Maximizing the natriuretic Peptide system in experimental heart failure: subcutaneous brain natriuretic Peptide and acute vasopeptidase inhibition
ARTICLE SOURCE: Circulation (United States), Feb 26 2002, 105(8) p999-1003
AUTHOR(S): Chen HH; Lainchbury JG; Harty GJ; Burnett JC
AUTHOR'S ADDRESS: Cardiorenal Research Laboratory, Division of Cardiovascular Diseases and Department of Physiology, Mayo Clinic and Foundation, Rochester, Minn.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: This study reports that acute Vasopeptidase inhibitors (VPIs) potentiates the cardiorenal actions of SQ BNP in experimental congestive heart failure (CHF). This study advances the concept that protein therapy with BNP together with vasopeptide inhibition represents a novel therapeutic strategy in CHF to maximize the beneficial properties of the natriuretic peptide system.

ARTICLE TITLE: Remodeling of left ventricular hypertrophy in elite athletes after long-term deconditioning
ARTICLE SOURCE: Circulation (United States), Feb 26 2002, 105(8) p944-9
AUTHOR(S): Pelliccia A; Maron BJ; De Luca R; Di Paolo FM; Spataro A; Culasso F
AUTHOR'S ADDRESS: Institute of Sports Science, Department of Medicine, Rome, Italy. ant.pelliccia@libero.it.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: LV remodeling was evident after long-term detraining, with significant reduction in cavity size and normalization of wall thickness. Resolution of cavity enlargement was, however, incomplete in most cases, and substantial chamber dilatation persisted in >20% of athletes. The possibility that this residual LV hypertrophy, apparently part of the athlete's heart syndrome, may have future long-term clinical implications in some individuals cannot be excluded with certainty.
MB: I never did think that athletic activity did any good.

ARTICLE TITLE: Importance of continuous chest compressions during cardiopulmonary resuscitation: improved outcome during a simulated single lay-rescuer scenario.
ARTICLE SOURCE: Circulation (United States), Feb 5 2002, 105(5) p645-9
AUTHOR(S): Kern KB; Hilwig RW; Berg RA; Sanders AB; Ewy GA
AUTHOR'S ADDRESS: University of Arizona Sarver Heart Center, Section of Cardiology, 85724, USA. kernk@u.arizona.edu.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Mouth-to-mouth ventilation performed by single layperson rescuers produces substantial interruptions in chest compression-supported circulation. Continuous chest compression CPR produces greater neurologically normal 24-hour survival than standard standard airway (A), breathing (B), and compression (C)ABC cardiopulmonary resuscitation (CPR) when performed in a clinically realistic fashion. Any technique that minimizes lengthy interruptions of chest compressions during the first 10 to 15 minutes of basic life support should be given serious consideration in future efforts to improve outcome results from cardiac arrest.

ARTICLE TITLE: New antiarrhythmic drugs for atrial flutter and atrial fibrillation: a conceptual breakthrough at last?
COMMENTS: Comment On: Comment On: RefSource:Circulation. 1991 Oct; 84(4):1831-51
ARTICLE SOURCE: Circulation (United States), Jan 22 2002, 105(3) p276-8
AUTHOR(S): Cosio FG; Delpon E
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Effectiveness of colonoscopy in preventing colorectal cancer.
ARTICLE SOURCE: Gastroenterology (United States), Dec 2001, 121(6) p1522
AUTHOR(S): Nelson DB
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Acid-base balance during repeated cycling sprints in boys and men
ARTICLE SOURCE: J Appl Physiol (United States), Feb 2002, 92(2) p479-85
AUTHOR(S): Ratel S; Duche P; Hennegrave A; Van Praagh E; Bedu M
AUTHOR'S ADDRESS: Laboratoire Interuniversitaire de Biologie des Activites Physiques et Sportives, F-63001 Clermont-Ferrand, France.
PUBLICATION TYPE: Journal Article
To conclude, during repeated sprints, the ventilatory regulation related to the change in acid-base balance induced by lactic acidosis was more important during the first rest intervals in the boys compared with the men.

ARTICLE TITLE: Comparison of acute cardiovascular responses to water immersion and head-down tilt in humans
ARTICLE SOURCE: J Appl Physiol (United States), Jan 2002, 92(1) p264-8
AUTHOR(S): Shiraishi M; Schou M; Gybel M; Christensen NJ; Norsk P
AUTHOR'S ADDRESS: Neurology Division, St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan.
PUBLICATION TYPE: Journal Article
In conclusion, the hypothesis was not confirmed because the cardiac atria were similarly distended by acute 6 degrees head-down tilt (HDT) and acute water immersion to the neck (WI) and the release of vasoconstrictor hormones were suppressed to the same extent.

ARTICLE TITLE: Acidosis following aortic cross-clamping: Is it the acid or carbon dioxide?
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Feb 2002, 16(1) p73-4
AUTHOR(S): Tobias JD; Johnson JO; Lemoine K; Lawson NW
AUTHOR'S ADDRESS: Departments of Anesthesiology and Child Health, The Division of Pediatric Critical Care/Pediatric Anesthesiology, The University of Missouri, Columbia, MO.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Epidural anesthesia and analgesia: Effects on recovery from cardiac surgery
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Feb 2002, 16(1) p15-20
AUTHOR(S): Fillinger MP; Yeager MP; Dodds TM; Fillinger MF; Whalen PK; Glass DD
AUTHOR'S ADDRESS: Departments of Anesthesiology and Surgery, Dartmouth-Hitchcock Medical Center, Lebanon; and Dartmouth Medical School, Hanover, NH.
PUBLICATION TYPE: Journal Article
MB: No benefit.

ARTICLE TITLE: What is the optimal morphine dose to be administered intrathecally in postoperative analgesia of cardiac surgery? ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Feb 2002, 16(1) p132-4
AUTHOR(S): Tamayo E; Alvarez J; de Temino R; Martinez A; Florez S
AUTHOR'S ADDRESS: Departments of Anesthesiology, Pharmacology and Therapeutics, and Cardiac Surgery, Clinical Hospital, Faculty of Medicine, University of Valladolid, Valladolid, Spain.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Nonradiologists reading radiographs: good medicine or stretching the scope of practice?
COMMENTS: Comment On: Comment On: RefSource:J Cardiothorac Vasc Anesth. 2001 Dec; 15(6):680-3
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Dec 2001, 15(6) p675-6
AUTHOR(S): Pfeifer M
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Chest radiograph interpretation skills of anesthesiologists.
COMMENTS: Comment In: Comment In: RefSource:J Cardiothorac Vasc Anesth. 2001 Dec; 15(6):675-6
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Dec 2001, 15(6) p680-3
AUTHOR(S): Kaufman B; Dhar P; O'Neill DK; Leitman B; Fermon CM; Wahlander SB; Sutin KM
AUTHOR'S ADDRESS: Department of Anesthesiology, New York University Medical Center, 550 First Avenue, New York, NY 10016, USA. KAUFNYUCCM@aol.com.
PUBLICATION TYPE: Journal Article
CONCLUSION: Anesthesiologists are deficient in skills for the interpretation of chest radiographs.
MB: I thought it was only me.

ARTICLE TITLE: Unruptured intracranial aneurysms: a review.
ARTICLE SOURCE: J Neurosurg (United States), Jan 2002, 96(1) p3-42
AUTHOR(S): Weir B
AUTHOR'S ADDRESS: Section of Neurosurgery, The University of Chicago, Illinois 60637-1470, USA.
PUBLICATION TYPE: Journal Article; Review; Review Literature

ARTICLE TITLE: Regional cerebrovascular and metabolic effects of hyperventilation after severe traumatic brain injury.
COMMENTS: Comment In: Comment In: RefSource:J Neurosurg. 2002 Jan; 96(1):155-7; Comment In: Comment In: RefSource:J Neurosurg. 2002 Jan; 96(1):157-9
ARTICLE SOURCE: J Neurosurg (United States), Jan 2002, 96(1) p103-8
AUTHOR(S): Diringer MN; Videen TO; Yundt K; Zazulia AR; Aiyagari V; Dacey RG; Grubb RL; Powers WJ
AUTHOR'S ADDRESS: Department of Neurology, Washington University School of Medicine, St Louis, Missouri 63110, USA. diringerm@neuro.wustl.edu.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Propofol-infusion syndrome.
COMMENTS: Comment On: Comment On: RefSource:J Neurosurg. 2001 Dec; 95(6):1053
ARTICLE SOURCE: J Neurosurg (United States), Dec 2001, 95(6) p925-6
AUTHOR(S): Kelly DF
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Metabolic acidosis, rhabdomyolysis, and cardiovascular collapse after prolonged propofol infusion.
COMMENTS: Comment In: Comment In: RefSource:J Neurosurg. 2001 Dec; 95(6):925-6
ARTICLE SOURCE: J Neurosurg (United States), Dec 2001, 95(6) p1053-6
AUTHOR(S): Cannon ML; Glazier SS; Bauman LA
AUTHOR'S ADDRESS: Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. mlcannon@wfubmc.edu.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Unrealistic expectations arising from mortality data reported in the cardiothoracic journals.
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Jan 2002, 123(1) p16-20
AUTHOR(S): Anyanwu AC; Treasure T
AUTHOR'S ADDRESS: St George's Hospital, London, United Kingdom.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Particularly for coronary artery bypass, published data tend to underrepresent the risk of death as seen in most centers. Outcomes and magnitudes of effects as reported in these research studies may not be replicable to the same degree in most centers. In particular, extreme caution should be taken in extrapolating results from studies with fewer than 100 patients to larger surgical populations.

ARTICLE TITLE: Paraplegia after open surgery using endovascular stent graft for aortic arch aneurysm.
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Dec 2001, 122(6) p1240-3
AUTHOR(S): Miyairi T; Kotsuka Y; Morota T; Kubota H; Shibata K; Ikeda Y; Kitamura T; Kashima T; Takamoto S
AUTHOR'S ADDRESS: Department of Cardiothoracic Surgery and Human Pathology, University of Tokyo, Tokyo, Japan. tmiyairi-tky@umin.ac.jp.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Vancomycin versus cefazolin prophylaxis for cardiac surgery in the setting of a high prevalence of methicillin-resistant staphylococcal infections
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Feb 2002, 123(2) p326-32
AUTHOR(S): Finkelstein R; Rabino G; Mashiah T; Bar-El Y; Adler Z; Kertzman V; Cohen O; Milo S
AUTHOR'S ADDRESS: Rambam Medical Center, Haifa, Israel. rfinkelstein@rambam.health.gov.il.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: This trial suggests that vancomycin and cefazolin have similar efficacy in preventing surgical site infections in cardiac surgery.

ARTICLE TITLE: Alkalosis induced by alpha-stat management: Cause of neuronal injury after deep hypothermic circulatory arrest?
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Feb 2002, 123(2) p394-5
AUTHOR(S): Wong C
AUTHOR'S ADDRESS: Department of Cardiothoracic SurgeryFreeman Hospital, Newcastle upon Tyne, United Kingdom.
PUBLICATION TYPE: Journal Article
MB: I have thought pH stat was better.
http://www.usyd.edu.au/su/anaes/lectures/acidbase_mjb/acidbase.html
http://www.usyd.edu.au/anaes/lectures/acidbase_mjb/phandtemp.html

ARTICLE TITLE: Benefits of prophylactic continuous infusion of furosemide after the maze procedure for atrial fibrillation
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Feb 2002, 123(2) p232-6
AUTHOR(S): Ad N; Suyderhoud JP; Kim YD; Makary MA; De Groot KW; Lue HC; Pirovic EA; Duvall WZ; Cox JL
AUTHOR'S ADDRESS: Department of Thoracic and Cardiovascular Surgery and the Division of Cardiac Anesthesiology, Georgetown University Medical Center, Washington, DC.
PUBLICATION TYPE:
Journal Article
ABSTRACT: OBJECTIVES: One of the most significant complications seen after the maze procedure for atrial fibrillation is excessive fluid retention, with subsequent pulmonary complications. CONCLUSION: Despite a smaller total dose relative to bolus infusion, prophylactic continuous furosemide infusion decreased the adverse pulmonary complications associated with excessive fluid retention in patients undergoing the maze procedure for atrial fibrillation.

ARTICLE TITLE: Acute renal failure and the sepsis syndrome
ARTICLE SOURCE: Kidney Int (United States), Feb 2002, 61(2) p764-76
AUTHOR(S): Schor N
AUTHOR'S ADDRESS: Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brasil.
PUBLICATION TYPE:
Journal Article

ARTICLE TITLE: Vascular access use in Europe and the United States: results from the DOPPS
ARTICLE SOURCE: Kidney Int (United States), Jan 2002, 61(1) p305-16
AUTHOR(S): Pisoni RL; Young EW; Dykstra DM; Greenwood RN; Hecking E; Gillespie B; Wolfe RA; Goodkin DA; Held PJ
AUTHOR'S ADDRESS: University Renal Research and Education Association, The University of Michigan, Veteran's Administration Medical Center, Ann Arbor, Michigan, USA. rlpisoni@urrea.org.
PUBLICATION TYPE:
Journal Article
CONCLUSION: Large differences in vascular access use exist between Europe (EUR) and the US, even after adjustment for patient characteristics. The results strongly suggest that a facility's preferences and approaches to vascular access practice are major determinants of vascular access use.

ARTICLE TITLE: Treatment of severe hyponatremia.
ARTICLE SOURCE: Kidney Int (United States), Dec 2001, 60(6) p2417-27
AUTHOR(S): Gross P
AUTHOR'S ADDRESS: Universitatsklinikum Carl Gustav Carus, Dresden, Federal Republic of Germany. peter.gross@mailbox.tu-dresden.de.
PUBLICATION TYPE: Clinical Conference; Journal Article

ARTICLE TITLE: Collusion detection in multiple choice examinations
ARTICLE SOURCE: Med Educ (England), Feb 2002, 36(2) p166-72
AUTHOR(S): Ercole A; Whittlestone KD; Melvin DG; Rashbass J
AUTHOR'S ADDRESS: Clinical and Biomedical Computing Unit, Clinical School, Addenbrooke's Hospital, Cambridge, UK.
PUBLICATION TYPE: Journal Article
One examination was formally invigilated, while the second was not; instead, candidates were able to sit the test at any time and at any computer with an internet connection. CONCLUSION: It is possible to detect collusion in multiple choice examinations in a statistical way by examining the patterns of answers between pairs of candidates. In examinations that are delivered on-line, information is often available on the location of the candidates and the timings of their answers, and can be used as additional corroborative evidence.
MB: What did they expect? We had invigilators in the Univ of Sydney too.

ARTICLE TITLE: The influence of admissions variables on first year medical school performance: a study from Newcastle University, Australia
ARTICLE SOURCE: Med Educ (England), Feb 2002, 36(2) p154-9
AUTHOR(S): Kay-Lambkin F; Pearson SA; Rolfe I
AUTHOR'S ADDRESS: Faculty of Medicine and Health Sciences, University of Newcastle, Australia.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Aboriginal and Torres Strait Islander, and overseas medical students had academic difficulties in the first year of the course, suggesting the need for extra course support. The result may reflect the educational and other obstacles these students must overcome in order to enter and progress through their medical degree. More research is warranted to explore the extent to which these differences persist throughout the medical degree.

ARTICLE TITLE: 'Arts and humanities': a new section in Medical Education
ARTICLE SOURCE: Med Educ (England), Feb 2002, 36(2) p106-7
AUTHOR(S): Macnaughton J
AUTHOR'S ADDRESS: Centre for Arts and Humanities in Health and Medicine University of Durhan Durham UK.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Anxiety and depression in the first year of medical residency training
ARTICLE SOURCE: Med Educ (England), Jan 2002, 36(1) p66-72
AUTHOR(S): Peterlini M; Tiberio IF; Saadeh A; Pereira JC; Martins MA
AUTHOR'S ADDRESS: Department of Medicine, School of Medicine, University of Sao Paulo, Brazil.
PUBLICATION TYPE: Journal Article
There were 2.1% of residents with symptoms compatible with severe, 4.2% with moderate and 27% with mild depression. It was possible to graduate symptoms of anxiety and depression in residents, evaluate factors involved in their genesis and locate residents with moderate and severe depression.

ARTICLE TITLE: The first year of doctoring: still a survival exercise
ARTICLE SOURCE: Med Educ (England), Jan 2002, 36(1) p2-3
AUTHOR(S): Bligh J
PUBLICATION TYPE: Editorial

ARTICLE TITLE: Perceptions of how well graduates are prepared for the role of pre-registration house officer: a comparison of outcomes from a traditional and an integrated PBL curriculum
ARTICLE SOURCE: Med Educ (England), Jan 2002, 36(1) p16-25
AUTHOR(S): Jones A; McArdle PJ; O'Neill PA
AUTHOR'S ADDRESS: Medical Education Unit, University of Manchester, Faculty of Medicine, Dentistry, Nursing and Pharmacy.
PUBLICATION TYPE:
Journal Article
RESULTS: Graduates rated the new course significantly more effective for 12 of the 19 broad competences and eight of the 13 specific skills that were listed. The 'new' graduates rated their understanding of disease processes lower than the 'traditional' graduates, but there was no difference in the ratings given by the educational supervisors for this. Overall the educational supervisors rated the new course as better preparing graduates in five of the competences.CONCLUSIONS: Overall, the evaluation shows that a major change in curriculum approach has changed the profile of the perceived preparedness of graduates for entering professional practice.
MB: It is not much good asking the victims what they notice.

ARTICLE TITLE: Sleep disturbances in the wake of traumatic events.
COMMENTS: Comment In: Comment In: RefSource:N Engl J Med. 2001 Dec 20; 345(25):1846-8
ARTICLE SOURCE: N Engl J Med (United States), Dec 20 2001, 345(25) p1825-32
AUTHOR(S): Lavie P
AUTHOR'S ADDRESS: Sleep Laboratory, Faculty of Medicine, Technion-Israel Institute of Technology, Technion City, Haifa, Israel.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Sudden death due to cardiac arrhythmias.
ARTICLE SOURCE: N Engl J Med (United States), Nov 15 2001, 345(20) p1473-82
AUTHOR(S): Huikuri HV; Castellanos A; Myerburg RJ
AUTHOR'S ADDRESS: Department of Medicine, University of Oulu, Finland. heikki.huikuri@oulu.fi.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
MB: Most have no accepted risk factors.

ARTICLE TITLE: Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation.
ARTICLE SOURCE: N Engl J Med (United States), Nov 8 2001, 345(19) p1378-87
AUTHOR(S): Bartelink H; Horiot JC; Poortmans P; Struikmans H; Van den Bogaert W; Barillot I; Fourquet A; Borger J; Jager J; Hoogenraad W; Collette L; Pierart M
AUTHOR'S ADDRESS: Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam. h.bartelink@nki.nl; Collective Name: European Organization for Research and Treatment of Cancer Radiotherapy and Breast Cancer Groups.
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
CONCLUSIONS: In patients with early breast cancer who undergo breast-conserving surgery and receive 50 Gy of radiation to the whole breast, an additional dose of 16 Gy of radiation to the tumor bed reduces the risk of local recurrence, especially in patients younger than 50 years of age.

ARTICLE TITLE: Early goal-directed therapy in the treatment of severe sepsis and septic shock.
COMMENTS: Comment In: Comment In: RefSource:N Engl J Med. 2001 Nov 8; 345(19):1417-8/PMID:11794176
ARTICLE SOURCE: N Engl J Med (United States), Nov 8 2001, 345(19) p1368-77
AUTHOR(S): Rivers E; Nguyen B; Havstad S; Ressler J; Muzzin A; Knoblich B; Peterson E; Tomlanovich M
AUTHOR'S ADDRESS: Department of Emergency Medicine, Henry Ford Health Systems, Case Western Reserve University, Detroit, MI 48202, USA. erivers1@hfhs.org; Collective Name: Early Goal-Directed Therapy Collaborative Group.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
ABSTRACT: BACKGROUND: Goal-directed therapy has been used for severe sepsis and septic shock in the intensive care unit. This approach involves adjustments of cardiac preload, afterload, and contractility to balance oxygen delivery with oxygen demand. The purpose of this study was to evaluate the efficacy of early goal-directed therapy before admission to the intensive care unit. CONCLUSIONS: Early goal-directed therapy provides significant benefits with respect to outcome in patients with severe sepsis and septic shock.

ARTICLE TITLE: High-normal blood pressure--more "high" than "normal"
COMMENTS: Comment On: Comment On: RefSource:N Engl J Med. 2001 Nov 1; 345(18):1291-7/PMID:11794147
ARTICLE SOURCE: N Engl J Med (United States), Nov 1 2001, 345(18) p1337-40
AUTHOR(S): Panza JA
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Impact of high-normal blood pressure on the risk of cardiovascular disease.
COMMENTS: Comment In: Comment In: RefSource:N Engl J Med. 2001 Nov 1; 345(18):1337-40/PMID:11794154
ARTICLE SOURCE: N Engl J Med (United States), Nov 1 2001, 345(18) p1291-7
AUTHOR(S): Vasan RS; Larson MG; Leip EP; Evans JC; O'Donnell CJ; Kannel WB; Levy D
AUTHOR'S ADDRESS: Framingham Heart Study, Mass 01702, USA. vasan@fram.nhlbi.nih.gov.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: High-normal blood pressure is associated with an increased risk of cardiovascular disease. Our findings emphasize the need to determine whether lowering high-normal blood pressure can reduce the risk of cardiovascular disease.

ARTICLE TITLE: Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest
ARTICLE SOURCE: N Engl J Med (United States), Feb 21 2002, 346(8) p549-56
AUTHOR'S ADDRESS: Collective Name: The Hypothermia after Cardiac Arrest Study Group.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: In patients who have been successfully resuscitated after cardiac arrest due to ventricular fibrillation, therapeutic mild hypothermia increased the rate of a favorable neurologic outcome and reduced mortality.

ARTICLE TITLE: Hypothermia to protect the brain
ARTICLE SOURCE: N Engl J Med (United States), Feb 21 2002, 346(8) p546
AUTHOR(S): Curfman GD
PUBLICATION TYPE Journal Article

ARTICLE TITLE: Daily hemodialysis--will treatment each day improve the outcome in patients with acute renal failure?
COMMENTS: Comment On: Comment On: RefSource:N Engl J Med. 2002 Jan 31; 346(5):305-10
ARTICLE SOURCE: N Engl J Med (United States), Jan 31 2002, 346(5) p362-4
AUTHOR(S): Bonventre JV
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Maintaining the public trust in clinical research.
ARTICLE SOURCE: N Engl J Med (United States), Jan 24 2002, 346(4) p285-7
AUTHOR(S): Kelch RP
AUTHOR'S ADDRESS: University of Iowa College of Medicine, Iowa City, IA 52242, USA.
PUBLICATION TYPE:Journal Article

ARTICLE TITLE: Migraine--current understanding and treatment.
ARTICLE SOURCE: N Engl J Med (United States), Jan 24 2002, 346(4) p257-70
AUTHOR(S): Goadsby PJ; Lipton RB; Ferrari MD
AUTHOR'S ADDRESS: Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK. peterg@ion.ucl.ac.uk.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Can the heart repair itself?
COMMENTS: Comment On: Comment On: RefSource:N Engl J Med. 2002 Jan 3; 346(1):5-15
ARTICLE SOURCE: N Engl J Med (United States), Jan 3 2002, 346(1) p2-4
AUTHOR(S): Schwartz RS; Curfman GD
PUBLICATION TYPE: Comment; Journal Article
MB: They have found myocardial cells with Y chromosones in female hearts transplanted into males. These new cell must have come form the recipient.

ARTICLE TITLE: Regeneration of the human heart--no chimera?
COMMENTS: Comment On: Comment On: RefSource:N Engl J Med. 2002 Jan 3; 346(1):5-15
ARTICLE SOURCE: N Engl J Med (United States), Jan 3 2002, 346(1) p55-6
AUTHOR(S): Bolli R
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Can beta blockers be safely initiated at home in patients with heart failure?
ARTICLE SOURCE: QJM (England), Jan 2002, 95(1) p55-6
AUTHOR(S): Wald DS; More RS; Martin M; Hughes L; Reid CJ
AUTHOR'S ADDRESS: Department of Cardiology, St. Mary's Hospital, Portsmouth. Department of Cardiology, St. Richards Hospital, Chichester.
PUBLICATION TYPE Journal Article

ARTICLE TITLE: Current controversies in shock and resuscitation.
ARTICLE SOURCE: Surg Clin North Am (United States), Dec 2001, 81(6) p1217-62, xi-xii
AUTHOR(S): Orlinsky M; Shoemaker W; Reis ED; Kerstein MD
AUTHOR'S ADDRESS: Department of Emergency Medicine, University of Southern California, Keck School of Medicine, Los Angeles County and University of Southern California Medical Center, Los Angeles 90033, USA. orlinsky@hsc.usc.edu.
PUBLICATION TYPE: Journal Article; Review; Review Literature

ARTICLE TITLE: The new neuromuscular blocking agents: do they offer any advantages?
ARTICLE SOURCE: Br J Anaesth 2001; Dec.87: 912-25
AUTHORS: E. W. Moore* and J. M. Hunter University Department of Anaesthesia, University Clinical Department, The Duncan Building, Daulby Street, Liverpool L69 3GA, UK*Corresponding author Declaration of interest: Over 3 yr ago, one of the authors, Prof. Hunter, was funded by Organon Teknika to carry out clinical investigations on rapacuronium
MB: Pity that rapacuronium has been withdrawn. One wonders how it got that far. I suppose it's because sux has never been under patent. I could not see any reason for continuously trying new one in the article.

ARTICLE TITLE: Comparison between dexmedetomidine and propofol for sedation in the intensive care
unit: patient and clinician perceptions
ARTICLE SOURCE: Br J Anaesth 2001; 87; 684-90
AUTHORS R. M. Venn1 and R. M. Grounds,2 1Department of Anaesthesia & Intensive Care, Worthing Hospital, Lyndhurst Road, Worthing, West Sussex BN11 2DH, UK. 2Department of Intensive Care Medicine, St George's
Hospital, Blackshaw Road, London SW17 OQT, UK*Corresponding author
This article is accompanied by Editorial I.
ABSTRACT: dexmedetomidine could be easily roused to cooperate with procedures (e.g. physiotherapy, radiology) without showing irritation. From the clinician's and patient's perspectives, dexmedetomidine is a safe and acceptable sedative agent for those requiring intensive care. The rate pressure product is reduced in patients receiving dexmedetomidine, which may protect against myocardial ischaemia. Dexmedetomidine reduces the requirement for opioid analgesia.

ARTICLE TITLE: Comparative efficacy and safety of remifentanil and fentanyl in 'fast track' coronary artery bypass graft surgery: a randomized, double-blind study
ARTICLE SOURCE: Br J Anaesth 2001; 87: 718-26
AUTHORS: T. Möllhoff *,1, L. Herregods2, A. Moerman2, D. Blake3, C. MacAdams4, R. Demeyere5, K. Kirnö6, T. Dybvik7, S. Shaikh8
and the Remifentanil Study Group 1Westfälische Wilhelms-Universität, Münster, Germany. 2Universitaire Ziekenhuis Gent, Ghent University Hospital, Belgium. 3Royal Melbourne Hospital, Melbourne, Australia. 4Foothills Hospital, Calgary, Canada. 5University Hospital Gasthuisberg, Leuven, Belgium. 6Sahlgrenska University Hospital, Göteborg, Sweden. 7Volvat Medical Centre, Oslo,
Norway. 8Glaxo Wellcome Research and Development, London, UK*Corresponding author: Abteilung Anästhesie, Intensivmedizin und Schmerztherapie, Marienhospital Aachen, Zeise 4, D-52066 Aachen, Germany
ABSTRACT: Overall, the incidence of adverse events was similar but greater in the remifentanil group with respect to shivering (P<0.049) and ypertension (P<0.001). Significantly more drug-related adverse events were reported in the remifentanil group (P=0.016) There were no drug-related adverse cardiac outcomes and no deaths from cardiac causes before hospital discharge in either treatment group

ARTICLE TITLE: Anaphylaxis during anaesthesia. Results of a two-year survey in France
ARTICLE SOURCE: Br J Anaesth 2001; Oct. 87: 549-58
AUTHORS: M. C. Laxenaire1, P. M. Mertes2 and Groupe d'Etudes des Réactions Anaphylactoïdes Peranesthésiques 1Département d'Anesthésie-réanimation, CHU de Nancy, Hôpital Central, 29 Avenue de Lattre de Tassigny, F-54035 Nancy Cedex, France. 2Laboratoire d'Explorations Fonctionnelles Respiratoires et Allergologiques, CHU-Hopital Maison Blanche, F-51092 Reims, France*Corresponding author
ABSTRACT: A significant difference was observed between the incidence of anaphylactic reactions observed with each neuromuscular blocking agent and the number of patients who received each drug during anaesthesia in France throughout the study period (P<0.0001). Succinylcholine and rocuronium were most frequently incriminated. Clinical reactions to neuromuscular blocking drugs were more severe than to latex. The diagnostic value of specific IgE assays was confirmed. These results are consistent with changes in the epidemiology of anaphylaxis related to anaesthesia and are an incentive for the further development of allergo-anaesthesia clinical networks.

ARTICLE TITLE: Effect of peri- and postoperative epidural anaesthesia on pain and gastrointestinal function after abdominal hysterectomy
ARTICLE SOURCE: Br J Anaesth 2001; Oct. 87: 577-83
AUTHORS: H. Jørgensen1, J. S. Fomsgaard1, J. Dirks1, J. Wetterslev1, B. Andreasson2 and J. B. Dahl1 1Department of Anaesthesiology and Intensive Care and 2Department of Obstetrics and Gynaecology, Herlev University Hospital, Copenhagen County, Denmark*Corresponding
author
ABSTRACT: A 24 h postoperative epidural infusion with bupivacaine, when added to postoperative paracetamol and NSAID, reduces pain and opioid requirements, but has only limited effects on gastrointestinal function and patient recovery.

ARTICLE TITLE: Prospective randomized, double-blind comparative study of dexamethasone, ondansetron, and ondansetron plus dexamethasone as prophylactic antiemetic therapy in patients undergoing day-case gynaecological surgery
ARTICLE SOURCE: Br J Anaesth 2001;Oct. 87: 588-92
AUTHORS: R. Thomas* and N. Jones. Department of Anaesthetics, North Hampshire Hospital, Aldermaston Road, Basingstoke, Hampshire RG24 9NA, UK*Corresponding author: Shackleton Department of Anaesthetics, Southampton General Hospital, Tremona Road, Southampton, Hampshire SO16 6YD, UK
ABSTRACT: The only significant difference between groups was seen in the first 3 h when failure of prophylaxis was more frequent in patients who had received dexamethasone alone (P=0.0085; Fisher's exact probability test). Confidence interval analysis indicates a modest treatment effect for the combination and the decision whether to perform a larger study depends upon whether such an effect is clinically relevant.
MB: I have lost interest PONV.

ARTICLE TITLE: Cardiac arrest associated with use of an argon beam coagulator during laparoscopic cholecystectomy
ARTICLE SOURCE: Br J Anaesth 2001; Oct. 87: 644'6
AUTHORS: M. Kono*,1, N. Yahagi2, M. Kitahara1, Y. Fujiwara1, M. Sha1 and A. Ohmura1 1Department of Anaesthesiology, Teikyo University School of Medicine, Mizonokuchi Hospital, Kawasaki 213-8507, Japan. 2Institute of Environmental Studies, Graduate School of Frontier Science, The University of Tokyo, Japan*Corresponding author

ARTICLE TITLE: The sitting position for neurosurgery in children: a review of 16 years' experience E. A. Harrison1, A. Mackersie*, A. ARTICLE SOURCE: Br J Anaesth 2002; Jan. 88: 12-17
AUTHORS: McEwan and E. Face Department of Anaesthesia, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK 1Present address: Department of Anaesthesia, The Hospital for Sick Children, 555 University Avenue, Toronto M5G 1X8, Canada*Corresponding author
This article is accompanied by Editorial I.
ABSTRACT: Background. Use of the sitting position for neurosurgery is controversial.. Conclusions. This is the largest study of the incidence of venous air embolus (VAE) in children undergoing neurosurgery. Our results suggest that the sitting position can be used safely for neurosurgery in children.
MB: Yeah. But is there any benefit?

ARTICLE TITLE: Randomized controlled trial to investigate influence of the fluid challenge on duration of hospital stay and perioperative morbidity in patients with hip fractures
ARTICLE SOURCE: Br J Anaesth 2002;Jan. 88: 65-71
AUTHORS: R. Venn1, A. Steele2, P. Richardson3, J. Poloniecki4, M. Grounds5 and P. Newman5 1Department of Anaesthesia and Intensive Care, Worthing Hospital, Lyndhurst Road, Worthing, W. Sussex BN11 2DH, UK. 2Department of Intensive Care, Hammersmith Hospital, Du Cane Rd, London W12 0HS, UK. 3St Andrews Centre, Broomfield Hospital, Court Rd, Chelmsford CM1 7EY, UK. 4St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK. 5Department of Intensive Care, St James Wing, St George's Hospital, Blackshaw Road, London SW17 0QT, UK*Corresponding author
ABSTRACT: Background. A prospective, randomized controlled trial comparing conventional intraoperative fluid management with two differing methods of invasive haemodynamic monitoring to optimize intraoperative fluid therapy, in patients undergoing proximal femoral fracture repair under general anaesthesia. Methods. Ninety patients randomized to three groups; conventional intraoperative fluid management (Gp CON, n=29), and two groups receiving additional repeated colloid fluid challenges guided by central venous pressure (Gp CVP, n=31) or oesophageal Doppler ultrasonography (Gp DOP, n=30). Primary outcome measures were time to medical fitness to discharge, hospital stay and postoperative morbidity There were no significant differences between groups, for survivors, with respect to acute orthopaedic hospital and total hospital stay. Conclusions. Invasive intraoperative haemodynamic monitoring with fluid challenges during repair of femoral fracture under general anaesthetic shortens time to being medically fit for discharge.
MB: The late George Davidson did a similar study at Sydney's Prince of Wales Hosp in about 1965. He used renal function as his end point. This and a renal failure after an AAA converted us to sustained hydration for vascular & other major surgery.

ARTICLE TITLE: Euthanasia and physician-assisted suicide: a review of the empirical data from the United States.
ARTICLE SOURCE: Arch Intern Med (United States), Jan 28 2002, 162(2) p142-52
AUTHOR(S): Emanuel EJ
AUTHOR'S ADDRESS: Department of Clinical Bioethics, Warren G. Magnuson Clinical Center, Bldg 10, Room 1C118, National Institutes of Health, Bethesda, MD 20892-1156, USA.
PUBLICATION TYPE: Journal Article; Review; Review, Academic

ARTICLE TITLE: Forecasting the impact of a clinical practice guideline for perioperative beta-blockers to reduce cardiovascular morbidity and mortality.
ARTICLE SOURCE: Arch Intern Med (United States), Jan 14 2002, 162(1) p63-9
AUTHOR(S): Schmidt M; Lindenauer PK; Fitzgerald JL; Benjamin EM
AUTHOR'S ADDRESS: Department of Biostatistics and Epidemiology, University of Massachusetts at Amherst, Amherst, MA, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: There seems to be a large opportunity to improve the quality of care of patients undergoing major noncardiac surgery by increasing the use of beta-blockers in the perioperative period. A clinical practice guideline may be one method to achieve these goals at little cost.

ARTICLE TITLE: Hypercoagulability syndromes.
ARTICLE SOURCE: Arch Intern Med (United States), Nov 12 2001, 161(20) p2433-9
AUTHOR(S): Thomas RH
AUTHOR'S ADDRESS: Department of General Medicine, University of Miami School of Medicine, 1475 NW 12th Ave, Third Floor, Miami, FL 33136, USA. rthomas@exhcg.com.
PUBLICATION TYPE Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Antibiotics for common respiratory tract infections in adults
ARTICLE SOURCE: Arch Intern Med (United States), Feb 11 2002, 162(3) p256-64
AUTHOR(S): Hirschmann JV
AUTHOR'S ADDRESS: Medical Service (111), Puget Sound Veterans Affairs Medical Center, University of Washington School of Medicine, 1660 S Columbian Way, Seattle, WA 98108, USA. pepsi@u.washington.edu.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Patient factors affecting autologous and allogeneic blood transfusion rates in total hip arthroplasty
ARTICLE SOURCE: Am J Orthop (United States), Dec 2001, 30(12) p867-71
AUTHOR(S): Marx RG; Wotherspoon S; Stephens D; Davey JR
AUTHOR'S ADDRESS: Center for Clinical Outcome Research, Hospital for Special Surgery, New York, New York, USA.
PUBLICATION TYPE: Journal Article
ABSTRACT: Factors that place patients undergoing total hip arthroplasty (THA) at increased risk of receiving an allogeneic or autologous blood transfusion may aid in determining which patients should predonate blood. The records of 354 consecutive patients undergoing THA were retrospectively reviewed to determine patient factors related to transfusion requirement. The risk of transfusion requirement was most strongly correlated with low preoperative hemoglobin level, but also with older age, higher American Society of Anesthesiologists physical status rating, female sex, cemented arthroplasty, and revision surgery. These patients were also least likely to predonate blood, likely because of their comorbid status.