MB's Articles of Interest - August 2002

ARTICLE TITLE: Study of the Therapeutic Effects of Intercessory Prayer (STEP): study design and research methods.
ARTICLE SOURCE: Am Heart J (United States), Apr 2002, 143(4) p577-84
AUTHOR(S): Dusek JA; Sherwood JB; Friedman R; Myers P; Bethea CF; Levitsky S; Hill PC; Jain MK; Kopecky SL; Mueller PS; Lam P; Benson H; Hibberd PL
AUTHOR'S ADDRESS: Mind/Body Medical Institute, Beth Israel Deaconess Medical Center, Caregroup, Department of Medicine, Harvard Medical School, Boston, Mass 02215, USA. jdusek@caregroup.harvard.edu.
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
RESULTS: The Study of the Therapeutic Effects of Intercessory Prayer (STEP) Data and Safety Monitoring Board reviewed patient safety and outcomes in the first 900 study patients. Patients were enrolled in STEP from January 1998 to November 2000.
MB: They don't tell us what happened.

ARTICLE TITLE: The effect of neuromuscular blockade on oxygen supply, consumption, and total chest compliance in patients with high oxygen requirements undergoing mechanical ventilation.
ARTICLE SOURCE: Anaesth Intensive Care (Australia), Apr 2002, 30(2) p192-7
AUTHOR(S): Russell WC; Greer R; Harper NJ
AUTHOR'S ADDRESS: Intensive Care Units, Leicester Royal Infirmary, UK.
PUBLICATION TYPE: Status: In-Process
Journal Article
There was no statistical difference in any of the parameters measured. However there were large changes in oxygen consumption (range -35% to +17%) and total chest compliance (range -19.7% to +9.7%) in individuals. We conclude that in the setting of critical oxygenation, neuromuscular blockade cannot be assumed to reduce oxygen requirements or improve total lung compliance. If, however, neuromuscular blockade is selected as an adjunct to therapy, we recommend that the indices of oxygenation are calculated.
MB: That's a pretty silly recommendation.

ARTICLE TITLE: Anaesthesia for endoluminal repair of abdominal aortic aneurysms
ARTICLE SOURCE: Anaesth Intensive Care (Australia), Feb 2002, 30(1) p66-70
AUTHOR(S): Davies MJ; Arhanghelschi I; Grauer R; Heard G; Scott DA
AUTHOR'S ADDRESS: Department of Anaesthesia, St Vincent's Hospital, Melbourne, Victoria.
PUBLICATION TYPE: Journal Article
ABSTRACT: An audit of 100 patients undergoing elective abdominal aortic surgery either by open aortic repair (OAR group 50 patients) or endovascular aortic repair (EAR group 50 patients) was undertaken to document changes in anaesthetic technique and perioperative outcome. The data for the OAR group was collected retrospectively and thatfor the EAR group prospectively. Combined general anaesthesia and thoracic epidural anaesthesia was used in 44 of the OAR group whereas lumbar central neural blockade alone was used in 47 of the EAR group. The major differences between the two groups were that intraoperative blood loss was significantly less in the EAR group (OAR 1,674 +/- 1,008 ml, EAR 459 +/- 350 ml, P<0.001) and that no patient in the EAR group required admission to the Intensive Care Unit (ICU), whereas ICU time for the OAR patients was 29 +/- 22 hours. Hospital stay was also significantly different between the two groups (OAR 13 +/- 6 days, EAR 5 +/- 3 days, P<0.001). Major complications occurred in 20patients in the OAR group but only 4patients in the EAR group (P<0.001). EAR reduces blood loss, the requirement for ICU admission, and hospital stay. Central neural blockade is a satisfactory anaesthetic technique for EAR.
MB: Ho hum.

ARTICLE TITLE: Incidents relating to arterial cannulation as identified in 7,525 reports submitted to the australian incident monitoring study (AIMS-ICU)
ARTICLE SOURCE: Anaesth Intensive Care (Australia), Feb 2002, 30(1) p60-5
AUTHOR(S): Durie M; Beckmann U; Gillies DM
AUTHOR'S ADDRESS: Department of Anaesthesia, Intensive Care, Pain Management, John Hunter Hospital, Newcastle, New South Wales.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: The peripherally inserted central catheter (PICC): a prospective study of its natural history after cubital fossa insertion ARTICLE SOURCE: Anaesth Intensive Care (Australia), Feb 2002, 30(1) p21-4
AUTHOR(S): Loewenthal MR; Dobson PM; Starkey RE; Dagg SA; Petersen A; Boyle MJ
AUTHOR'S ADDRESS: Immunology and Infectious Diseases Unit, John Hunter Hospital, Newcastle, New South Wales.
PUBLICATION TYPE: Journal Article
ABSTRACT: A prospective cohort study was undertaken to describe the natural history of the cubital fossa peripherally inserted central catheter (PICC), determine which factors influenced the hazard of complication and develop a standard methodology for evaluation of a PICC service. A total of 4349 patient days of PICC observation were analysed using survival analysis techniques. The median time to PICC removal for a complication was 60 days. The most common complications were phlebitis, malposition and tip migration. Complications usually occurred during the first week. There was only one episode of line-related sepsis. Size 3 French gauge catheters had a complication rate of 7.3 per 1,000 line days compared to 14.2 for 4 French catheters (hazard rate 1.26 90% CI 1.02 to 1.55). PICCs requiring two or more attempts at insertion were more likely to develop complications than those inserted at the first attempt: 20 per 1,000 line days vs 10.5 but the confidence intervals were wide (hazard rate 1.91, 90% CI 0.90 to 4.05). Operator (amongst the four experienced operators who inserted all PICCs), arm of placement, or medial or lateral placement in the cubitalfossa did not influence PICC survival.

ARTICLE TITLE: Recurrent pulmonary embolism during liver transplantation: possible role of hepatitis B immune globulin as a causative agent.
ARTICLE SOURCE: Anesthesiology (United States), May 2002, 96(5) p1261-3
AUTHOR(S): Wong WH; Braunfeld M; Levin P
AUTHOR'S ADDRESS: Department of Anesthesiology, University of California-Los Angeles School of Medicine, Los Angeles, California, USA. whwkc@yahoo.com.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty.
ARTICLE SOURCE: Anesthesiology (United States), May 2002, 96(5) p1140-6
AUTHOR(S): Mantilla CB; Horlocker TT; Schroeder DR; Berry DJ; Brown DL
AUTHOR'S ADDRESS: Department of Anesthesiology, Health Sciences Research, and Orthopedic Surgery, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. mantilla.carlos@mayo.edu.
PUBLICATION TYPE: Journal Article
RESULTS: A total of 10,244 patients underwent primary total hip or knee arthroplasty in the period of study. Of these, 224 patients had one or more adverse events (overall event rate: 2.2%; myocardial infarction: 0.4%; pulmonary embolism: 0.7%; deep venous thrombosis: 1.5%; death: 0.5%). Most adverse events (myocardial infarction, pulmonary embolism, and death) increased in frequency with older age, particularly for patients aged 70 yr or older. Myocardial infarction occurred more frequently in male patients. There were no differences in the overall event frequency between types of procedure. However, pulmonary embolism was highest in patients undergoing bilateral knee operations. CONCLUSIONS: The overall frequency of serious complications within 30 days after primary total hip or knee arthroplasty with contemporary practice was 2.2%. Accurate knowledge of the perioperative risks associated with widely performed elective operations can be used to implement management strategies that may further improve patient outcomes and decrease cost.

ARTICLE TITLE: Anesthesiologist board certification and patient outcomes.
COMMENTS: Comment In: Comment In: RefSource:Anesthesiology. 2002 May; 96(5):1039-41
ARTICLE SOURCE: Anesthesiology (United States), May 2002, 96(5) p1044-52
AUTHOR(S): Silber JH; Kennedy SK; Even-Shoshan O; Chen W; Mosher RE; Showan AM; Longnecker DE
AUTHOR'S ADDRESS: Center for Outcomes Research, Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Pennsylvania 19094, USA. Silberj@Wharton.Upenn.Edu.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: When anesthesiology board certification is very common, as in midcareer practitioners, the lack of board certification is associated with worse outcomes. However, the poor outcomes associated with noncertified providers may be a result of the hospitals at which they practice and not necessarily their manner of practice.

ARTICLE TITLE: Perioperative risk: how can we study the influence of provider characteristics?
COMMENTS: Comment On: Comment On: RefSource:Anesthesiology. 2002 May; 96(5):1044-52
ARTICLE SOURCE: Anesthesiology (United States), May 2002, 96(5) p1039-41
AUTHOR(S): Fleisher LA; Anderson GF
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Practice guidelines for sedation and analgesia by non-anesthesiologists.
ARTICLE SOURCE: Anesthesiology (United States), Apr 2002, 96(4) p1004-17
AUTHOR'S ADDRESS: Collective Name: American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists.
PUBLICATION TYPE: Guideline; Journal Article; Practice Guideline

ARTICLE TITLE: Monitors of depth of anesthesia, quo vadis?
COMMENTS: Comment On: Comment On: RefSource:Anesthesiology. 2002 Apr; 96(4):803-16
ARTICLE SOURCE: Anesthesiology (United States), Apr 2002, 96(4) p784-7
AUTHOR(S): Kalkman CJ; Drummond JC
PUBLICATION TYPE: Comment; Editorial
MB: This is a sensible philosophical examination of the possibility of valid instrumental monitoring of efficacy of anaesthesia on subjective experience in patients.

ARTICLE TITLE: Bilateral continuous interscalene block of brachial plexus for analgesia after bilateral shoulder arthroplasty.
ARTICLE SOURCE: Anesthesiology (United States), Mar 2002, 96(3) p762-4
AUTHOR(S): Maurer K; Ekatodramis G; Hodler J; Rentsch K; Perschak H; Borgeat A
AUTHOR'S ADDRESS: Department of Anesthesiology, Orthopedic University Clinic Zurich/Balgrist, Zurich, Switzerland.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: No preemptive analgesia: is that so bad?
COMMENTS: Comment On: Comment On: RefSource:Anesthesiology. 2002 Mar; 96(3):725-41
ARTICLE SOURCE: Anesthesiology (United States), Mar 2002, 96(3) p526-7
AUTHOR(S): Hogan QH
PUBLICATION TYPE: Comment; Editorial
MB: Comments on a meta-analysis of 80 studies. Essentially it does not work.

ARTICLE TITLE: Measurement of pain in children: state-of-the-art considerations.
COMMENTS: Comment On: Comment On: RefSource:Anesthesiology. 2002 Mar; 96(3):528-35
ARTICLE SOURCE: Anesthesiology (United States), Mar 2002, 96(3) p523-6
AUTHOR(S): Kain ZN; Cicchetti DV; McClain BC
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Validation of the Non-communicating Children's Pain Checklist-Postoperative Version.
COMMENTS: Comment In: Comment In: RefSource:Anesthesiology. 2002 Mar; 96(3):523-6
ARTICLE SOURCE: Anesthesiology (United States), Mar 2002, 96(3) p528-35
AUTHOR(S): Breau LM; Finley GA; McGrath PJ; Camfield CS
AUTHOR'S ADDRESS: Pediatric Pain Research Laboratory, IWK Health Centre, Halifax, Nova Scotia, Canada. lbreau@ns.sympatico.ca.
PUBLICATION TYPE: Clinical Trial; Journal Article; Validation Studies
CONCLUSIONS: The Non-communicating Children's Pain Checklist-Postoperative Version (NCCPC-PV) displayed good psychometric properties when used for the postoperative pain of children with severe intellectual disabilities and has the potential to be useful in a clinical setting. The results suggest familiarity with an individual child with intellectual disabilities is not necessary for pain assessment.

ARTICLE TITLE: Thirty-day postoperative death rate at an academic medical center
ARTICLE SOURCE: Ann Surg (United States), May 2002, 235(5) p690-6; discussion 696-8
AUTHOR(S): Calland JF; Adams RB; Benjamin DK; O'Connor MJ; Chandrasekhara V; Guerlain S; Jones RS
AUTHOR'S ADDRESS: Department of Surgery, University of Virginia Health Systems, Charlottesville, Virginia 22908, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Overall, the 30-day postoperative death rate was low in the total surgical population at an academic medical center. Errors and adverse events (AEs) were associated with 12.6% and 19.3% of deaths, respectively. Retrospective review inadequately characterized the nature of AEs and failed to determine causality. Prospective audits of outcomes will enhance our understanding of surgical AEs.

ARTICLE TITLE: New era of liver transplantation for hepatitis B: a 17-year single-center experience
ARTICLE SOURCE: Ann Surg (United States), May 2002, 235(5) p611-20
AUTHOR(S): Anselmo DM; Ghobrial RM; Jung LC; Weaver M; Cao C; Saab S; Kunder G; Chen PW; Farmer DG; Yersiz H; Baquerizo A; Geevarghese S; Han SH; Goldstein L; Holt CD; Gornbein JA; Busuttil RW
AUTHOR'S ADDRESS: Department of Surgery, Dumont-UCLA Liver Transplant Center, UCLA School of Medicine, Los Angeles, California.
PUBLICATION TYPE: Status: In-Process
Journal Article
CONCLUSIONS: Orthotopic liver transplantation for hepatitis B virus (HBV) under combination viral prophylaxis results in survival rates equivalent to other indications. Pretransplant viral replication, United Network for Organ Sharing (UNOS) status, and the presence of Hepatocellular carcinoma (HCC) are all sensitive markers for posttransplantation outcome. Viral prophylactic therapy has effectively reduced HBV recurrence and prolonged survival outcomes. The combination of hepatitis B immune globulin (HBIg) and lamivudine is the prophylactic regimen of choice.

ARTICLE TITLE: Variation in death rate after abdominal aortic aneurysmectomy in the United States: impact of hospital volume, gender, and age.
ARTICLE SOURCE: Ann Surg (United States), Apr 2002, 235(4) p579-85
AUTHOR(S): Dimick JB; Stanley JC; Axelrod DA; Kazmers A; Henke PK; Jacobs LA; Wakefield TW; Greenfield LJ; Upchurch GR
AUTHOR'S ADDRESS: Section of Vascular Surgery, Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, and Division of Vascular Surgery, Wayne State University School of Medicine, Detroit, Michigan.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: This study from a representative national database documents that high-volume hospitals (HVHs) have a significantly lower death rate than with low-volume hospitals (LVHs) for repair of both intact and ruptured AAA. These data support the regionalization of patients to HVHs for after abdominal aortic aneurysm (AAA) repair.
MB: It's always the same. I've seen no studies indicating better results with fewer patients.

ARTICLE TITLE: Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials.
ARTICLE SOURCE: Ann Surg (United States), Mar 2002, 235(3) p322-32
AUTHOR'S ADDRESS: Health Services Research Unit, University of Aberdeen, UK; Collective Name: The EU Hernia Trialists Collaboration.
PUBLICATION TYPE: Journal Article; Meta-Analysis
CONCLUSIONS: The use of synthetic mesh substantially reduces the risk of hernia recurrence irrespective of placement method. Mesh repair appears to reduce the chance of persisting pain rather than increase it.

ARTICLE TITLE: Randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia.
ARTICLE SOURCE: Br J Surg (England), Mar 2002, 89(3) p293-7
AUTHOR(S): Vrijland WW; van den Tol MP; Luijendijk RW; Hop WC; Busschbach JJ; de Lange DC; van Geldere D; Rottier AB; Vegt PA; IJzermans JN; Jeekel J
AUTHOR'S ADDRESS: Departments of Surgery, University Hospital Rotterdam--Dijkzigt, The Netherlands.
CONCLUSION: Mesh repair of primary inguinal hernia repair is superior to non-mesh repair with regard to hernia recurrence and is cost-effective. Postoperative complications, pain and quality of life did not differ between groups.

ARTICLE TITLE: Danish nationwide cohort study of postoperative death in patients with liver cirrhosis undergoing hernia repair
ARTICLE SOURCE: Br J Surg (England), Jun 2002, 89(6) p805-6
AUTHOR(S): Hansen JB; Thulstrup AM; Vilstup H; Sorensen HT
AUTHOR'S ADDRESS: Department of Medical Gastroenterology, Aalborg Hospital, Aalborg, Department of Medicine V (Hepatology and Gastroenterology) and Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Economic evaluation of a randomized clinical trial of haemodilution with cell salvage in aortic surgery
ARTICLE SOURCE: Br J Surg (England), Jun 2002, 89(6) p731-6
AUTHOR(S): Haynes SL; Torella F; Wong JC; Dalrymple K; James M; McCollum CN
AUTHOR'S ADDRESS: Academic Surgery Unit, South Manchester University Hospital, Wythenshawe, Manchester and Department of Health Planning and Management, University of Keele, Keele, UK.
PUBLICATION TYPE: Status: In-Process
Journal Article
ABSTRACT: BACKGROUND: This study evaluated the costs of acute normovolaemic haemodilution (ANH) and intraoperative cell salvage (ICS) versus homologous blood transfusion in aortic surgery in a prospective multicentre randomized trial.METHODS: One hundred and forty-five patients were randomized either to standard transfusion practice (homologous) or to a combination of ANH and ICS (autologous). Costs for each inpatient admission were identified. Cell salvage costs were assigned on the assumption that 50 operations were done each year employing a trained cell salvage operator. The results were analysed statistically using bias-corrected bootstrap analysis.RESULTS: Patients who had transfusion of homologous blood received some 251 units and those having a homologous transfusion received 103 units (P = 0.008). There was no difference in morbidity, mortality and duration of hospital stay. Transfusion-related mean costs were similar at pound340 for patients having a homologous transfusion and pound357 for those receiving autologous blood (mean difference pound17 (95 per cent confidence interval (c.i.) - pound184 to pound174); P not significant). There was also no significant difference in mean overall costs: pound5859 for homologous and pound5384 for autologous transfusion (mean difference - pound475 (95 per cent c.i. - pound2231 to pound1342)). Sensitivity analysis showed that costs remained similar for 20 and 150 operations per annum. Exclusion of a dedicated cell salvage operator reduced autologous transfusion costs but did not have a significant impact on overall cost.CONCLUSION: Autologous transfusion is cost neutral in aortic surgery even when surgical activity is low.
MB: When we do open AAAs here we have virtually zero homologous transfusion when using intraoperative salvage without haemodilution. We tried haemodilution.

ARTICLE TITLE: A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair
ARTICLE SOURCE: Br J Surg (England), Jun 2002, 89(6) p714-30
AUTHOR(S): Bown MJ; Sutton AJ; Bell PR; Sayers RD
AUTHOR'S ADDRESS: Departments of Surgery and Epidemiology and Public Health, University of Leicester, Leicester, UK.
PUBLICATION TYPE: Journal Article
CONCLUSION: Contrary to the conclusion of recent studies, this paper demonstrates a gradual reduction with time in the operative mortality rate of ruptured abdominal aortic aneurysm (RAAA) repair.

ARTICLE TITLE: Fracture of the penis
ARTICLE SOURCE: Br J Surg (England), May 2002, 89(5) p555-65
AUTHOR(S): Eke N
AUTHOR'S ADDRESS: Urology Unit, Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
PUBLICATION TYPE: Journal Article
CONCLUSION: Penile fracture is not rare. Radiological investigations are expensive and may delay treatment. Current management favours early surgical exploration to prevent complications.

ARTICLE TITLE: Desflurane improves the throughput of patients in the PACU. A cost-effectiveness comparison with isoflurane:
ARTICLE SOURCE: Can J Anaesth (Canada), Apr 2002, 49(4) p339-46
AUTHOR(S): Beaussier M; Decorps A; Tilleul P; Megnigbeto A; Balladur P; Lienhart A
AUTHOR'S ADDRESS: Department of Anesthesia and Intensive Care, the Department of Pharmacy, and the Department of Surgery, St Antoine University Hospital, and the University Paris XIII, Paris, France.
PUBLICATION TYPE: Journal Article
DISCUSSION: Improving the throughput of patients in PACU by using new halogenated anesthetic agents with faster rates of elimination may outweigh the incremental cost of this strategy. This becomes particularly meaningful in operating theatres experiencing frequent overcrowded periods.
MB: Not a randomised blind controlled trial.

ARTICLE TITLE: Best evidence in anesthetic practice: Prevention: dopamine does not prevent death, acute renal failure, or need for dialysis ARTICLE SOURCE: Can J Anaesth (Canada), Apr 2002, 49(4) p417-9
AUTHOR(S): Bracco D; Parlow JL
AUTHOR'S ADDRESS: Lausanne, Switzerland Kingston, Ontario.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Science, pseudoscience and Sellick
ARTICLE SOURCE: Can J Anaesth (Canada), May 2002, 49(5) p443-7
AUTHOR(S): Maltby JR; Beriault MT
AUTHOR'S ADDRESS: Department of Anesthesia, Foothills Medical Centre, Calgary, Alberta, Canada.
PUBLICATION TYPE: Journal Article
MB: Not a very logical discussion.

ARTICLE TITLE: Effect of faecal occult blood screening on mortality from colorectal cancer: results from a randomised controlled trial ARTICLE SOURCE: Gut (England), Jun 2002, 50(6) p840-4
AUTHOR(S): Scholefield JH; Moss S; Sufi F; Mangham CM; Hardcastle JD
AUTHOR'S ADDRESS: Division of GI Surgery, University Hospital, Nottingham NG7 2UH, UK Cancer Screening Evaluation Unit, Sutton, Surrey SM2 5NG, UK.
PUBLICATION TYPE: Journal Article
METHODS: The 152 850 randomised individuals were followed up through local health records and central flagging (Office for National Statistics) over a median follow up period of 11 years. RESULTS: At a median follow up of 11 years there was a 13% reduction in colorectal cancer mortality (95% confidence interval 3-22%) in the intervention group despite an uptake at first invitation of only approximately 50%. The mortality reduction for those accepting screening was 27%. The reduction in mortality was independent of sex and site of tumour. There was no significant difference in mortality from causes other than colorectal cancer between the intervention and control groups. CONCLUSIONS: Although the reduction in colorectal cancer mortality was sustained, further follow up of this population is required to determine whether a significant reduction in the incidence of colorectal cancer will be achieved.

ARTICLE TITLE: What do physicians think about evidence-based antibiotic use in critical care? A survey of Australian intensivists and infectious disease practitioners.
ARTICLE SOURCE: Intern Med J (Australia), Nov 2001, 31(8) p462-9
AUTHOR(S): Sintchenko V; Iredell JR; Gilbert GL; Coiera E
AUTHOR'S ADDRESS: Centre for Health Informatics, Faculty of Medicine, University of New South Wales, Sydney, Australia. v.sintchenko@student.unsw.edu.au.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Australian clinicians have positive views about evidence-based prescribing and antibiotic guidelines. However, there are clinically significant differences in prescribing behaviour between intensive care unit practitioners (ICUP) and infectious disease practitioners (IDP). These may be explained by different disease spectra managed by each group or different cultures, training and/or cognitive styles. Improvements in the understanding of physicians' information and decision support needs are required to strengthen evidence-based prescribing.
MB: These variations should be resolved.

ARTICLE TITLE: Doctors' interactions with the pharmaceutical industry: science or commerce?
COMMENTS: Comment On: Comment On: RefSource:Intern Med J. 2001 Nov; 31(8):488-91
ARTICLE SOURCE: Intern Med J (Australia), Nov 2001, 31(8) p446-7
AUTHOR(S): Komesaroff P
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Surgical tracheostomy versus percutaneous dilatational tracheostomy. A prospective-randomized study with long-term follow-up.
ARTICLE SOURCE: J Cardiovasc Surg (Torino) (Italy), Feb 2002, 43(1) p113-21
AUTHOR(S): Melloni G; Muttini S; Gallioli G; Carretta A; Cozzi S; Gemma M; Zannini P
AUTHOR'S ADDRESS: Department of Thoracic Surgery, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy. melloni.giulio@hsr.it.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: This study confirms that percutaneous dilatational tracheostomy (PDT)is a simpler and quicker procedure than surgical tracheostomy (ST) and that it has a lower rate of early postoperative complications. Late tracheal complications were more frequent, although the difference was not statistically-significant, in the PDT group. Further investigations of long-term outcome following PDT are therefore necessary.
MB: All similar studies do not show this outcome.

ARTICLE TITLE: Renal dose dopamine in open heart surgery. Does it protect renal tubular function?
ARTICLE SOURCE: J Cardiovasc Surg (Torino) (Italy), Feb 2002, 43(1) p25-30
AUTHOR(S): Yavuz S; Ayabakan N; Dilek K; Ozdemir A
AUTHOR'S ADDRESS: Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Hospital, Bursa, Turkey.
PUBLICATION TYPEClinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: Consequently, in patients with normal preoperative renal and cardiac function scheduled for elective coronary artery bypass grafting, renal dose dopamine infusion alone may not provide sufficient protection on tubular function and increases renal tubular injury during the early postoperative period.

ARTICLE TITLE: Spinal anesthesia for endoluminal abdominal aortic aneurysm repair
ARTICLE SOURCE: J Clin Anesth (United States), May 2002, 14(3) p176-8
AUTHOR(S): Huang JJ
AUTHOR'S ADDRESS: Resident in Anesthesiology, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
PUBLICATION TYPE: Journal Article
CONCLUSION: Endoluminal abdominal aortic aneurysm (AAA) repair can be safely performed with spinal anesthesia. The major disadvantage of spinal anesthesia is limited duration of anesthesia. The anesthesia team must be prepared to induce general anesthesia at any time. The decision regarding anesthetic technique should focus on patient and physician needs and preferences.
MB: Why bother. GA is alright from the outset.

ARTICLE TITLE: Dose requirements and recovery profile of an infusion of cisatracurium during liver transplantation
ARTICLE SOURCE: J Clin Anesth (United States), Mar 2002, 14(2) p135-9
AUTHOR(S): Cammu G; Bossuyt G; De Baerdemaeker L; Den Blauwen N; Struys M; Mortier E
AUTHOR'S ADDRESS: Department of Anesthesia, Ghent University Hospital, Belgium. Guy.Cammu@olvz-aalst.be.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The infusion dose requirement for cisatracurium during liver transplantation tended to be higher than previously reported in healthy patients; recovery appeared prolonged. In continuous infusion of cisatracurium during liver transplantation, the tendency toward higher dose requirements, the protracted duration of infusion, the non-Hofmann elimination and/or other pharmacokinetic changes during transplantation might influence recovery from the neuromuscular block. Potential temperature or pH change during surgery seemed irrelevant in explaining the delayed recovery.

ARTICLE TITLE: If HIV/AIDS is Punishment, Who is Bad?
ARTICLE SOURCE: J Med Philos (Netherlands), Apr 2002, 27(2) p231-43
AUTHOR(S): Kopelman LM
AUTHOR'S ADDRESS: Department of Medical Humanities, Brody School of Medicine at East Carolina University, Greenville, NC1, USA.
PUBLICATION TYPE: Status: In-Process
Journal Article
ABSTRACT: HIV/AIDS strikes with the greatest frequency in sub-Saharan Africa, a region lacking resources to deal with this epidemic. To keep millions more people from dying, wealthy countries must provide more help. Yet deeply ingrained biases may distance the sick from those who could provide far more aid. One such prejudice is viewing disease as punishment for sin. This 'punishment theory of disease" ascribes moral blame to those who get sick or those with special relations to them. Religious versions hold that God punishes them in order to castigate, encourage virtue, warn, rehabilitate, or maintain some cosmic order. Its various religious and secular forms are untenable; they lack cogency, risk blaming people unjustly, and jeopardize compassionate care for people. These views are not only irrational but also dangerous because they influence policies and cost lives. We need to cooperate and respond as befits this global public-health disaster and not engage in the misguided and bad faith activity of dividing the world into the blameworthy and blameless.

ARTICLE TITLE: Trust, moral responsibility, the self, and well-ordered societies: the importance of basic philosophical concepts for clinical ethics.
ARTICLE SOURCE: J Med Philos (Netherlands), Feb 2002, 27(1) p3-9
AUTHOR(S): Mccullough LB
AUTHOR'S ADDRESS: Baylor College of Medicine, Houston, TX 77030, USA. mccullou@bcm.tmc.edu.
PUBLICATION TYPE: Journal Article
ABSTRACT: Although the work of clinical ethics is intensely practical, it employs and presumes philosophical concepts from the central branches of philosophy, including metaphysics, epistemology, ethics, and political philosophy. This essay introduces this issue in the Journal on clinical ethics by considering how the papers and book reviews included in it illuminate four such concepts: trust, moral responsibility, the self and well-ordered societies.

ARTICLE TITLE: Trust in medicine.
ARTICLE SOURCE: J Med Philos (Netherlands), Feb 2002, 27(1) p11-29
AUTHOR(S): Clark CC
AUTHOR'S ADDRESS: College of Staten Island, CUNY, NY 10014, USA. chalmerscc@aol.com.
PUBLICATION TYPE: Journal Article
ABSTRACT: Trust relations in medicine are argued to be a requisite response to the special vulnerability of persons as patients. Even so, the problem of motivating trust remains a vital concern. On this score, it is argued that a strong motivation can be found in recognizing that professional self-interest actually entails cultivation of patient trust as a means to maintain professional self-governance. And while the initial move to restore trust must be provoked from such narrow concerns, the process of sustaining trust will require educational initiatives aimed at restoring attitudes and skills suggestive of Percival's concept of empathic care. By including such initiatives, future waves of medical professionals are apt to sustain trust with deepened commitments to character, care, and trust as constitutive properties of their professional mission.

ARTICLE TITLE: From the Centers for Disease Control and Prevention. Hypothermia-related deaths--Utah, 2000, and United States, 1979-1998.
ARTICLE SOURCE: JAMA (United States), Feb 27 2002, 287(8) p981-2
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial.
COMMENTS: Comment In: Comment In: RefSource:JAMA. 2002 Mar 27; 287(12):1578-80
ARTICLE SOURCE: JAMA (United States), Mar 27 2002, 287(12) p1541-7
AUTHOR(S): Cuffe MS; Califf RM; Adams KF; Benza R; Bourge R; Colucci WS; Massie BM; O'Connor CM; Pina I; Quigg R; Silver MA; Gheorghiade M
AUTHOR'S ADDRESS: Northwestern University Medical School, Division of Cardiology, 201 E Huron St, Galter 10-240, Chicago, IL 60611, USA. m-gheorghiade@northwestern.edu; Collective Name: The Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Investigators.
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
CONCLUSION: These results do not support the routine use of intravenous milrinone as an adjunct to standard therapy in the treatment of patients hospitalized for an exacerbation of chronic heart failure.

ARTICLE TITLE: Treatment of acute heart failure: out with the old, in with the new.
COMMENTS: Comment On: Comment On: RefSource:JAMA. 2002 Mar 27; 287(12):1531-40; Comment On: Comment On: RefSource:JAMA. 2002 Mar 27; 287(12):1541-7
ARTICLE SOURCE: JAMA (United States), Mar 27 2002, 287(12) p1578-80
AUTHOR(S): Poole-Wilson PA
PUBLICATION TYPE: Comment; Editorial
MB: It is about acute cardiac failure, including the above study. The theory is hopeless. There are also theoretical problems with chronic cardiac failure.

ARTICLE TITLE: Protecting the brain in coronary artery bypass graft surgery.
COMMENTS: Comment On: Comment On: RefSource:JAMA. 2002 Mar 20; 287(11):1405-12
ARTICLE SOURCE: JAMA (United States), Mar 20 2002, 287(11) p1448-50
AUTHOR(S): Mark DB; Newman MF
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: beta-Blockers and reduction of cardiac events in noncardiac surgery: clinical applications.
ARTICLE SOURCE: JAMA (United States), Mar 20 2002, 287(11) p1445-7
AUTHOR(S): Auerbach AD; Goldman L
AUTHOR'S ADDRESS: Department of Medicine, Box 0120, University of California, San Francisco, San Francisco, CA 94143-0120, USA. ada@medicine.ucsf.edu.
PUBLICATION TYPE: Journal Article
ABSTRACT: Recent studies suggest that beta-blockers administered perioperatively may reduce the risk of adverse cardiac events and mortality in patients who have cardiac risk factors and undergo major noncardiac surgery. The objective of this article is to provide practicing physicians with examples of perioperative beta-blocker use in practice by using several hypothetical cases. Although current evidence describing the effectiveness of perioperative beta-blockade may not address all possible clinical situations, it is possible to formulate an evidence-based approach that will maximize benefit to patients. We describe how information from several sources can be used to guide management of patients with limited exercise tolerance, those at highest risk for perioperative cardiac events, patients who are taking beta-blockers long-term, and those with relative contraindications to beta-blockade. Even though fine points of their use remain to be elucidated, perioperative beta-blocker use is important and can be easily applied in practice by any physician involved with the care of patients perioperatively.

ARTICLE TITLE: beta-Blockers and reduction of cardiac events in noncardiac surgery: scientific review.
ARTICLE SOURCE: JAMA (United States), Mar 20 2002, 287(11) p1435-44
AUTHOR(S): Auerbach AD; Goldman L
AUTHOR'S ADDRESS: Department of Medicine, Box 0120, University of California-San Francisco, San Francisco, CA 94143-0120, USA. ada@medicine.ucsf.edu.
PUBLICATION TYPE: Journal Article; Review; Review, Academic
CONCLUSIONS: Despite heterogeneity of trials, a growing literature suggests a benefit of beta-blockade in preventing perioperative cardiac morbidity. Evidence from these trials can be used to formulate an effective clinical approach while definitive trials are awaited.

ARTICLE TITLE: Cognitive outcome after off-pump and on-pump coronary artery bypass graft surgery: a randomized trial.
COMMENTS: Comment In: Comment In: RefSource:JAMA. 2002 Mar 20; 287(11):1448-50
ARTICLE SOURCE: JAMA (United States), Mar 20 2002, 287(11) p1405-12
AUTHOR(S): Van Dijk D; Jansen EW; Hijman R; Nierich AP; Diephuis JC; Moons KG; Lahpor JR; Borst C; Keizer AM; Nathoe HM; Grobbee DE; De Jaegere PP; Kalkman CJ
AUTHOR'S ADDRESS: Department of Anaesthesiology, University Medical Center, PO Box 85500 (HpN E03-511), 3508 GA Utrecht, the Netherlands; Collective Name: The Octopus Study Group.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSION: Patients who received their first coronary artery bypass graft (CABG) surgery without cardiopulmonary bypass had improved cognitive outcomes 3 months after the procedure, but the effects were limited and became negligible at 12 months.

ARTICLE TITLE: Postoperative nausea and vomiting--can it be eliminated?
ARTICLE SOURCE: JAMA (United States), Mar 13 2002, 287(10) p1233-6
AUTHOR(S): Gan TJ
AUTHOR'S ADDRESS: Department of Anesthesiology, Duke University Medical Center, Box 3094, Durham, NC 27710, USA. gan00001@mc.duke.edu.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
MB: They are more optimistic than I am.

ARTICLE TITLE: MSJAMA. The changing role of dissection in medical education.
ARTICLE SOURCE: JAMA (United States), Mar 6 2002, 287(9) p1180-1
AUTHOR(S): Gregory SR; Cole TR
AUTHOR'S ADDRESS: University of Texas Medical Branch at Galveston, USA.
PUBLICATION TYPE: Historical Article; Journal Article

ARTICLE TITLE: Patient safety efforts should focus on medical errors.
COMMENTS: Comment On: Comment On: RefSource:JAMA. 2002 Apr 17; 287(15):1993-7
ARTICLE SOURCE: JAMA (United States), Apr 17 2002, 287(15) p1997-2001
AUTHOR(S): McNutt RA; Abrams R; Arons DC
AUTHOR'S ADDRESS: Department of Medicine, Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill 60612, USA. robert_mcnutt@rush.edu; Collective Name: Patient Safety Committee.
PUBLICATION TYPE: Comment; Journal Article

ARTICLE TITLE: Patient safety efforts should focus on medical injuries.
COMMENTS: Comment In: Comment In: RefSource:JAMA. 2002 Apr 17; 287(15):1997-2001; Erratum In: Erratum In: RefSource:JAMA 2002 May 8; 287(18):2363/Note:Maas Leslie A [corrected to Cortes Leslie M]
ARTICLE SOURCE: JAMA (United States), Apr 17 2002, 287(15) p1993-7
AUTHOR(S): Layde PM; Cortes LM; Teret SP; Brasel KJ; Kuhn EM; Mercy JA; Hargarten SW; Maas LA
AUTHOR'S ADDRESS: Injury Research Center at the Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA. playde@mcw.edu.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Changes in anesthesiology practice are explicated.
ARTICLE SOURCE: JAMA (United States), Apr 17 2002, 287(15) p1924-6
AUTHOR(S): Torpy JM
PUBLICATION TYPE: News
MB: Mostly waffle about obstetric analgesia.

ARTICLE TITLE: Preoperative beta-blocker use and mortality and morbidity following CABG surgery in North America.
ARTICLE SOURCE: JAMA (United States), May 1 2002, 287(17) p2221-7
AUTHOR(S): Ferguson TB; Coombs LP; Peterson ED
AUTHOR'S ADDRESS: Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA 70012-2822, USA. tbruceferg732@pol.net; Collective Name: The Society of Thoracic Surgeons National Adult Cardiac Surgery Database.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: In this large North American observational analysis, preoperative beta-blocker therapy was associated with a small but consistent survival benefit for patients undergoing coronary artery bypass graft surgery (CABG), except among patients with a left ventricular ejection fraction of less than 30%. This analysis further suggests that preoperative beta-blocker therapy may be a useful process measure for CABG quality improvement assessment.

ARTICLE TITLE: Editorial: Pulmonary hypertension, (high) risk of orthotopic liver transplantation, and some lessons from "primary" pulmonary hypertension
ARTICLE SOURCE: Liver Transpl (United States), Apr 2002, 8(4) p389-90
AUTHOR(S): Krowka MJ
AUTHOR'S ADDRESS: Divisions of Pulmonary and Critical Care Medicine and Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Outcome of liver transplantation for patients with pulmonary hypertension
ARTICLE SOURCE: Liver Transpl (United States), Apr 2002, 8(4) p382-8
AUTHOR(S): Starkel P; Vera A; Gunson B; Mutimer D
AUTHOR'S ADDRESS: Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Birmingham, UK.
PUBLICATION TYPE: Journal Article
ABSTRACT: It is generally believed that pulmonary hypertension (PHT) adversely affects outcome after liver transplantation (LT). Most transplant units consider severe PHT to be an absolute contraindication to LT. We examined the outcome of 145 patients who underwent LT between 1997 and 1999. Pulmonary artery pressures (PAPs) had been measured before surgery. Pre-LT workup included electrocardiography and echocardiography for the majority of patients. Also, the liver unit database was screened for patients with known PHT who had undergone LT before 1997. Based on pulmonary floatation catheter measurements made after the induction of anesthesia for LT, PHT was defined as mild or moderate to severe if the mean PAP (MPAP) exceeded 25 and 35 mm Hg, respectively. The incidence of PHT was 26% (38 of 145 patients); 31 of 38 patients had mild PHT. Kaplan-Meier survival analysis did not show a significant survival benefit for patients with normal PAPs compared with patients with PHT (all, mild, moderate to severe). For surviving patients, the duration of ventilation and intensive care unit stay was unaffected by PHT. Four of 5 patients (identified from the database 1982 to 1999) with MPAPs greater than 40 mm Hg survived LT by more than 1 year. PHT of this severity was usually associated with specific and suggestive abnormality of the echocardiogram. Mild PHT is common and does not affect patient outcome after LT. Moderate and severe PHT are uncommon. Our analysis suggests that when the cardiac index is preserved, the majority of patients with moderate and severe PHT can survive LT, and they will not die of PHT during long-term follow-up. Echocardiography detects most severe PHT, but not mild and moderate PHT.

ARTICLE TITLE: Monitoring extracellular concentrations of lactate, glutamate, and glycerol by in vivo microdialysis in the brain during liver transplantation in acute liver failure
ARTICLE SOURCE: Liver Transpl (United States), Mar 2002, 8(3) p302-5
AUTHOR(S): Tofteng F; Larsen FS
AUTHOR'S ADDRESS: Department of Hepatology, Rigshospitalet, University Hospital of Copenhagen, Denmark.
PUBLICATION TYPE: Status: In-Process
Journal Article
ABSTRACT: Swelling of cerebral glial cells is a characteristic complication in patients with acute liver failure (ALF). This astrocyte edema may result in high intracranial pressure (ICP) and brain herniation before or during liver transplantation. Metabolic alterations responsible for the development of high ICP in patients with ALF are not fully understood. We describe changes in neurochemistry during liver transplantation using a cerebral microdialysis technique in a young man with severe ALF and cerebral edema. We found that the extracellular content of lactate ([lactate](ec)) gradually increased during the operation. Becauce cerebral oxygen saturation and [lactate](ec) to [pyruvate](ec) ratio were within normal limits, hypoxia was not likely to be responsible for the increased [lactate](ec) levels. Instead, we found that [lactate](ec) levels correlated in this patient with arterial lactate concentrations during and after grafting (r(2) = 0.96; P <.05), but did not correlate with arterial glucose concentrations (r(2) = 0.20; P = not significant). Also, [glutamate](ec) and [glycerol](ec) levels were severely elevated before liver transplantation, but tended to decrease in the hours after grafting. These findings indicate disturbances in glutamate neurotransmission, arachidonic acid metabolism, and lactate flux across the blood-brain barrier in patients with ALF.

ARTICLE TITLE: The economic value of medical research: is it worth the investment?
ARTICLE SOURCE: Obstet Gynecol (United States), May 2002, 99(5) p835-40
AUTHOR(S): Peipert JF
AUTHOR'S ADDRESS: Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University Medical School, Providence, Rhode Island, USA.
PUBLICATION TYPE: Status: In-Process
Journal Article
CONCLUSION:Our nation's contribution into medical research provides a very high "return on investment." The likely returns from research are so favorable that the payoff from any "portfolio" of research investments would be enormous.
MB: It may not apply to Australia.

ARTICLE TITLE: A randomized controlled trial of early oral analgesia in gynecologic oncology patients undergoing intra-abdominal surgery
ARTICLE SOURCE: Obstet Gynecol (United States), May 2002, 99(5) p704-8
AUTHOR(S): Pearl ML; McCauley DL; Thompson J; Mahler L; Valea FA; Chalas E
AUTHOR'S ADDRESS: Departments of Obstetrics, Gynecology and Reproductive Medicine, and Surgery, Division of Gynecologic Oncology, State University of New York at Stony Brook, Stony Brook, New York, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS:Early oral analgesia in gynecologic oncology patients undergoing intra-abdominal surgery is safe and efficacious.

ARTICLE TITLE: A randomized, clinical trial of oral midazolam plus placebo versus oral midazolam plus oral transmucosal fentanyl for sedation during laceration repair.
ARTICLE SOURCE: Pediatrics (United States), May 2002, 109(5) p894-7
AUTHOR(S): Klein EJ; Diekema DS; Paris CA; Quan L; Cohen M; Seidel KD
AUTHOR'S ADDRESS: Department of Pediatrics, University of Washington and Children's Hospital and Regional Medical Center, Seattle, Washington 98105-0371, USA. eklein@chmc.org.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: The addition of oral transmucosal fentanyl to oral midazolam did not improve pain or activity scores in pediatric patients given sedation for laceration repair. Patients who received Fentanyl Oralet suffered significantly more side effects despite the relatively low doses administered in this study. Oral transmucosal fentanyl should not be used for procedural sedation in the ED.

ARTICLE TITLE: Reduced risk of sudden death from chest wall blows (commotio cordis) with safety baseballs.
ARTICLE SOURCE: Pediatrics (United States), May 2002, 109(5) p873-7
AUTHOR(S): Link MS; Maron BJ; Wang PJ; Pandian NG; Vander Brink BA; Estes NA
AUTHOR'S ADDRESS: Center for the Cardiovascular Evaluation of Athletes, the Cardiac Arrhythmia Center, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. mlink@lifespan.org.
PUBLICATION TYPE: Journal Article
CONCLUSION: In this experimental model of low-energy chest wall impact, safety baseballs reduced (but did not abolish) the risk of sudden cardiac death. More universal use of these safety baseballs may decrease the risk of sudden death on the playing field for young athletes.
MB: They tried pigs. Why not just give up base ball? Maybe they could have chest protector like those used in cricket.

ARTICLE TITLE: How should a fever mercury thermometer be disposed of ? A survey of those likely to be asked.
ARTICLE SOURCE: Pediatrics (United States), May 2002, 109(5) pE71-1
AUTHOR(S): Di Carlo M; Ruck B; Marcus S
AUTHOR'S ADDRESS: Rutgers University-College of Pharmacy and the New Jersey Poison Information and Education System at the University of Medicine and Dentistry of New Jersey, Newark, New Jersey 07107, USA.
PUBLICATION TYPE: Journal Article
ABSTRACT: The American Academy of Pediatrics' recent technical report entitled "Mercury in the Environment: Implications for Pediatricians" was widely reported on by the news media. After the media reports, the New Jersey Poison Information and Education System experienced a notable increase in the volume of calls on this topic. We surveyed local, county, and state health officers who would likely be contacted by citizens with the question: "How should a fever mercury thermometer be disposed of?" Our initial contacts with health officers corroborated our caller's account: a lack of uniformity of response. This led us to question if there was any consensus in advice being offered to the public at large.

ARTICLE TITLE: Detection of pulsus paradoxus associated with large pericardial effusions in pediatric patients by analysis of the pulse-oximetry waveform.
ARTICLE SOURCE: Pediatrics (United States), Apr 2002, 109(4) p673-7
AUTHOR(S): Tamburro RF; Ring JC; Womback K
AUTHOR'S ADDRESS: Division of Critical Care Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA. robert.tamburro@stjude.org.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Analysis of pulse-oximetry waveforms may be a widely available, easily interpretable, and reliable method of detecting the pulsus paradoxus associated with large pericardial effusions in pediatric patients.

ARTICLE TITLE: Poor readability of written asthma management plans found in national guidelines.
ARTICLE SOURCE: Pediatrics (United States), Apr 2002, 109(4) pe52
AUTHOR(S): Forbis SG; Aligne CA
AUTHOR'S ADDRESS: Strong Children's Research Center, University of Rochester, Rochester, New York 14620-3917, USA. shalini_forbis@urmc.rochester.edu.
PUBLICATION TYPE: Evaluation Studies; Journal Article
CONCLUSION: Written asthma management plans (WAMPs) presented as part of the national guidelines are not written at or below a fifth-grade reading level. However, it is clear from this study that it is possible to achieve this level of readability. Increasing the availability and use of plans that meet recognized readability standards may help to improve asthma outcomes, especially in poor populations in which there is both low literacy and the greatest prevalence and severity of asthma.

ARTICLE TITLE: Self-esteem as a predictor of initiation of coitus in early adolescents.
ARTICLE SOURCE: Pediatrics (United States), Apr 2002, 109(4) p581-4
AUTHOR(S): Spencer JM; Zimet GD; Aalsma MC; Orr DP
AUTHOR'S ADDRESS: Hamilton Center Section of Adolescent Medicine, Indianapolis, Indiana, USA.
PUBLICATION TYPE: Journal Article
ABSTRACT: OBJECTIVE: To examine the role of self-esteem in predicting coitus initiation in a population of early adolescents. METHODS: Questionnaires assessing coital status, self-esteem, and pubertal maturation were collected from 188 participants who had not engaged in coitus by enrollment. Data were collected longitudinally while the participants were in the seventh and ninth grade. Ages ranged from 12 to 14 (mean: 12.50; standard deviation: 0.57) at Time 1 and from 14 to 16 (mean: 14.30; standard deviation: 0.49) at Time 2. RESULTS: Boys with higher self-esteem ratings at Time 1 were more likely to initiate intercourse by Time 2. Girls with higher self-esteem at Time 1 were more likely to remain virgins than girls with lower self-esteem. Pubertal status was unrelated to initiation of coitus in this sample. CONCLUSIONS: Self-esteem, regardless of pubertal status, predicted coitus transition differentially in boys and girls. Results from this longitudinal study seem to fit within traditional problem behavior theory.

ARTICLE TITLE: Oxygen and resuscitation: beyond the myth.
ARTICLE SOURCE: Pediatrics (United States), Mar 2002, 109(3) p517-9
AUTHOR(S): Lefkowitz W
AUTHOR'S ADDRESS: Walter Reed Army Medical Center, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA. wlefkowitz@usuhs.mil.
PUBLICATION TYPE: Journal Article
MB: Not a very sensible casting of doubt on the possibility that oxygen during acute resuscitation because lack of positive evidence that using oxygen rather than air increases success. They seem to have fallen for the positivist belief/heresy that only if evidence exists can we know.

ARTICLE TITLE: Do current results of endovascular abdominal aortic aneurysm repair justify more widespread use?
ARTICLE SOURCE: Surgery (United States), Apr 2002, 131(4) p363-7
AUTHOR(S): Brewster DC
AUTHOR'S ADDRESS: Massachusetts General Hospital and Harvard Medical School, One Hawthorne Place, Suite 111, Boston, MA 02114, USA.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Are autopsies useful? Do premorbid findings predict postmortem results in head and neck cancer patients?
ARTICLE SOURCE: Ann R Coll Surg Engl (England), Mar 2002, 84(2) p133-6
AUTHOR(S): Jennings CR; Bradley PJ
AUTHOR'S ADDRESS: Department of ENT, Queens Medical Centre, University Hospital, Nottingham, UK.
PUBLICATION TYPE: Status: In-Process
Journal Article
ABSTRACT: A total of 53 autopsies were analysed in patients with head and neck squamous carcinoma. The discordance rate, that is the proportion of autopsies that revealed new information, was 53%. One-third of patients did not die of cancer. Clinical findings either misdiagnosed or under-diagnosed loco regional disease in 34% of cases, and distant malignant disease in 36% of cases. It appears that the autopsy reveals new and useful information in the head and neck cancer patient, and consent should be sought.

ARTICLE TITLE: Hair tying as a method of scalp wound closure
ARTICLE SOURCE: Ann R Coll Surg Engl (England), Mar 2002, 84(2) p127-8
AUTHOR(S): Dheansa B; Overstall S
AUTHOR'S ADDRESS: Department of Plastic Surgery, St George's Hospital, London, UK. baljit.dheansa@virgin.net.
PUBLICATION TYPE: Journal Article
MB: Cool

ARTICLE TITLE: Are we really as good as we think we are?
ARTICLE SOURCE: Ann R Coll Surg Engl (England), Jan 2002, 84(1) p54-6
AUTHOR(S): Evans AW; Aghabeigi B; Leeson R; O'Sullivan C; Eliahoo J
AUTHOR'S ADDRESS: Department of Oral and Maxillofacial Surgery, Eastman Dental Institute for Oral Health Care Sciences, University College London, UK.
PUBLICATION TYPE: Journal Article
ABSTRACT: Differences are examined in assessment and self-assessment scores, in oral and maxillofacial surgery trainees and MSc postgraduates, following the surgical removal of lower third molar teeth. This study found evidence of a surprising and worrying over-rating of their own surgical skills by many trainees and postgraduates.

ARTICLE TITLE: The outcome of drug smuggling by 'body packers'--the British experience.
ARTICLE SOURCE: Ann R Coll Surg Engl (England), Jan 2002, 84(1) p35-8
AUTHOR(S): Bulstrode N; Banks F; Shrotria S
AUTHOR'S ADDRESS: Ashford Hospital, Middlesex, UK.
PUBLICATION TYPE: Journal Article
ABSTRACT: Body packing or internal concealment used by drug dealers to smuggle illicit substances, puts the body packer at risk of both imprisonment and death. We report our experience over a 4 year period from January 1996 to December 1999 of suspects presenting to our hospital (the largest series in Europe). A total of 572 cases were assessed radiographically and 180 were shown to be carrying foreign bodies. The commonest reasons for admission were suspected overdose or gastrointestinal obstruction. Thirty-six cases were admitted, of whom 7 required surgical intervention. No deaths occurred. Of all people detained for smuggling by internal concealment into Britain during this period, 27% were seen in our hospital. These cases may present alone or escorted by Her Majesty's Customs and Excise personnel, and one must be aware of this possibility even when situated away from a port of entry.

ARTICLE TITLE: Value of bispectral index monitoring during cardiopulmonary resuscitation.
ARTICLE SOURCE: Br J Anaesth (England), Mar 2002, 88(3) p443-4
AUTHOR(S): Szekely B; Saint-Marc T; Degremont AC; Castelain MH; Fischler M
AUTHOR'S ADDRESS: Department of Anaesthesiology, Hjpital Foch, Suresnes, France.
PUBLICATION TYPE: Journal Article
ABSTRACT: A 67-yr-old man, undergoing pulmonary metastasis resection, experienced a postoperative cardiopulmonary arrest as a result of severe bleeding. Cardiopulmonary resuscitation (CPR) was initiated, then bispectral index (BIS) monitoring was used which reassured the medical team of the adequacy of the resuscitation.
MB: I think it is important to make the resuscitators feel good.

ARTICLE TITLE: Effects of remifentanil and alfentanil on the cardiovascular responses to induction of anaesthesia and tracheal intubation in the elderly.
ARTICLE SOURCE: Br J Anaesth (England), Mar 2002, 88(3) p430-3
AUTHOR(S): Habib AS; Parker JL; Maguire AM; Rowbotham DJ; Thompson JP
AUTHOR'S ADDRESS: University Department of Anaesthesia, Critical Care and Pain Management, University Hospitals of Leicester, Leicester Royal Infirmary, UK.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: Remifentanil and alfentanil similarly attenuate the pressor response to laryngoscopy and intubation, but the incidence of hypotension confirms that both drugs should be used with caution in elderly patients.
MB: You either give it or you don't

ARTICLE TITLE: Remifentanil by patient-controlled analgesia compared with intramuscular meperidine for pain relief in labour.
ARTICLE SOURCE: Br J Anaesth (England), Mar 2002, 88(3) p374-8
AUTHOR(S): Thurlow JA; Laxton CH; Dick A; Waterhouse P; Sherman L; Goodman NW
AUTHOR'S ADDRESS: Department of Anaesthesia, Southmead Hospital, Westbury-on-Trym, Bristol, UK.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSION: In this pilot study, remifentanil by PCA gave better pain relief to mothers in labour than intramuscular meperidine. However, remifentanil is a potent respiratory depressant and adequate continuous monitoring is necessary.
MB: How about using the same drug in both trials.

ARTICLE TITLE: Development and use of scoring systems for assessment of clinical competence.
COMMENTS: Comment On: Comment On: RefSource:Br J Anaesth. 2002 Mar; 88(3):338-44
ARTICLE SOURCE: Br J Anaesth (England), Mar 2002, 88(3) p329-30
AUTHOR(S): Glavin RJ; Maran NJ
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: The past, present, and future of the implantable cardioverter defibrillator
ARTICLE SOURCE: Am J Med (United States), May 2002, 112(7) p577-9
AUTHOR(S): Kupersmith J
AUTHOR'S ADDRESS: Department of Medicine, Texas Tech University School of Medicine, Lubbock, Texas, USA.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Does participation in a long-term clinical trial lead to survival gain for patients with coronary artery disease?
ARTICLE SOURCE: Am J Med (United States), May 2002, 112(7) p545-8
AUTHOR(S): Tenenbaum A; Motro M; Fisman EZ; Boyko V; Mandelzweig L; Shotan A; Behar S
AUTHOR'S ADDRESS: Cardiac Rehabilitation Institute (AT, MM, EZF), Neufeld Cardiac Research Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
PUBLICATION TYPE: Journal Article
Participation in a long-term clinical trial in a country with readily accessible community-based medicine may not lead to survival gain in patients with coronary artery disease.
MB: It should not.

ARTICLE TITLE: Can clinical evaluation differentiate diastolic from systolic heart failure? If so, is it important?
COMMENTS: Comment On: Comment On: RefSource:Am J Med. 2002 Apr 15; 112(6):437-45
ARTICLE SOURCE: Am J Med (United States), Apr 15 2002, 112(6) p496-7
AUTHOR(S): Cheitlin MD
PUBLICATION TYPE: Comment; Editorial
MB: Apparently systolic failure means low ejection fraction. It make no difference to therapy so making the distinction is not important. Apparently many (including me) can't hear S3 gallops.

ARTICLE TITLE: Hospital outcomes in major teaching, minor teaching, and nonteaching hospitals in New York state.
COMMENTS: Comment In: Comment In: RefSource:Am J Med. 2002 Mar; 112(4):314-5
ARTICLE SOURCE: Am J Med (United States), Mar 2002, 112(4) p255-61
AUTHOR(S): Polanczyk CA; Lane A; Coburn M; Philbin EF; Dec GW; Di Salvo TG
AUTHOR'S ADDRESS: Heart Failure and Cardiac Transplantation Unit, Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
PUBLICATION TYPE: Journal Article
CONCLUSION: Major teaching hospital status was an important determinant of outcomes in patients hospitalized with myocardial infarction, heart failure, or stroke in New York State.
MB: It'd be worrying if it did not.

[Editor's note: I added the following one. I'd hate to be the one responsible for collecting the signature of all 494 authors on the manuscript. We have a long way to go in medicine before we catch up to this. JL.]

ARTICLE TITLE: Upsilon production and polarization in p p macro collisions at square root of s = 1.8 TeV.
ARTICLE SOURCE: Phys Rev Lett 2002 Apr 22;88(16):161802
AUTHOR(S): Acosta D, Affolder T, Akimoto H, Albrow MG, Amaral P, Ambrose D, Amidei D, Anikeev K, Antos J, Apollinari G, Arisawa T, Artikov A, Asakawa T, Ashmanskas W, Azfar F, Azzi-Bacchetta P, Bacchetta N, Bachacou H, Bailey S, de Barbaro P, Barbaro-Galtieri A, Barnes VE, Barnett BA, Baroiant S, Barone M, Bauer G, Bedeschi F, Belforte S, Bell WH, Bellettini G, Bellinger J, Benjamin D, Bensinger J, Beretvas A, Berge JP, Berryhill J, Bhatti A, Binkley M, Bisello D, Bishai M, Blair RE, Blocker C, Bloom K, Blumenfeld B, Blusk SR, Bocci A, Bodek A, Bolla G, Bonushkin Y, Bortoletto D, Boudreau J, Brandl A, van den Brink S, Bromberg C, Brozovic M, Brubaker E, Bruner N, Buckley-Geer E, Budagov J, Budd HS, Burkett K, Busetto G, Byon-Wagner A, Byrum KL, Cabrera S, Calafiura P, Campbell M, Carithers W, Carlson J, Carlsmith D, Caskey W, Castro A, Cauz D, Cerri A, Chan AW, Chang PS, Chang PT, Chapman J, Chen C, Chen YC, Cheng MT, Chertok M, Chiarelli G, Chirikov-Zorin I, Chlachidze G, Chlebana F, Christofek L, Chu ML, Chung JY, Chung YS, Ciobanu CI, Clark AG, Colijn AP, Connolly A, Convery M, Conway J, Cordelli M, Cranshaw J, Culbertson R, Dagenhart D, D'Auria S, DeJongh F, Dell'Agnello S, Dell'Orso M, Demers S, Demortier L, Deninno M, Derwent PF, Devlin T, Dittmann JR, Dominguez A, Donati S, Done J, D'Onofrio M, Dorigo T, Eddy N, Einsweiler K, Elias JE, Engels E Jr, Erbacher R, Errede D, Errede S, Fan Q, Fang HC, Feild RG, Fernandez JP, Ferretti C, Field RD, Fiori I, Flaugher B, Foster GW, Franklin M, Freeman J, Friedman J, Fukui Y, Furic I, Galeotti S, Gallas A, Gallinaro M, Gao T, Garcia-Sciveres M, Garfinkel AF, Gatti P, Gay C, Gerdes DW, Gerstein E, Giannetti P, Giordani M, Giromini P, Glagolev V, Glenzinski D, Gold M, Goldstein J, Gorelov I, Goshaw AT, Gotra Y, Goulianos K, Green C, Grim G, Gris P, Grosso-Pilcher C, Guenther M, Guillian G, Guimaraes da Costa J, Haas RM, Haber C, Hahn SR, Hall C, Handa T, Handler R, Hao W, Happacher F, Hara K, Hardman AD, Harris RM, Hartmann F, Hatakeyama K, Hauser J, Heinrich J, Heiss A, Herndon M, Hill C, Hocker A, Hoffman KD, Hollebeek R, Holloway L, Huffman BT, Hughes R, Huston J, Huth J, Ikeda H, Incandela J, Introzzi G, Ivanov A, Iwai J, Iwata Y, James E, Jones M, Joshi U, Kambara H, Kamon T, Kaneko T, Karagoz Unel M, Karr K, Kartal S, Kasha H, Kato Y, Keaffaber TA, Kelley K, Kelly M, Khazins D, Kikuchi T, Kilminster B, Kim BJ, Kim DH, Kim HS, Kim MJ, Kim SB, Kim SH, Kim YK, Kirby M, Kirk M, Kirsch L, Klimenko S, Koehn P, Kondo K, Konigsberg J, Korn A, Korytov A, Kovacs E, Kroll J, Kruse M, Kuhlmann SE, Kurino K, Kuwabara T, Laasanen AT, Lai N, Lami S, Lammel S, Lancaster J, Lancaster M, Lander R, Lath A, Latino G, LeCompte T, Lee K, Leone S, Lewis JD, Lindgren M, Liss TM, Liu JB, Liu YC, Litvintsev DO, Lobban O, Lockyer NS, Loken J, Loreti M, Lucchesi D, Lukens P, Lusin S, Lyons L, Lys J, Madrak R, Maeshima K, Maksimovic P, Malferrari L, Mangano M, Mariotti M, Martignon G, Martin A, Martin V, Matthews JA, Mazzanti P, McFarland KS, McIntyre P, Menguzzato M, Menzione A, Merkel P, Mesropian C, Meyer A, Miao T, Miller R, Miller JS, Minato H, Miscetti S, Mishina M, Mitselmakher G, Miyazaki Y, Moggi N, Moore E, Moore R, Morita Y, Moulik T, Mulhearn M, Mukherjee A, Muller T, Munar A, Murat P, Murgia S, Nachtman J, Nagaslaev V, Nahn S, Nakada H, Nakano I, Nelson C, Nelson T, Neu C, Neuberger D, Newman-Holmes C, Ngan CY, Niu H, Nodulman L, Nomerotski A, Oh SH, Oh YD, Ohmoto T, Ohsugi T, Oishi R, Okusawa T, Olsen J, Orejudos W, Pagliarone C, Palmonari F, Paoletti R, Papadimitriou V, Partos D, Patrick J, Pauletta G, Paulini M, Paus C, Pellett D, Pescara L, Phillips TJ, Piacentino G, Pitts KT, Pompos A, Pondrom L, Pope G, Prokoshin F, Proudfoot J, Ptohos F, Pukhov O, Punzi G, Rakitine A, Ratnikov F, Reher D, Reichold A, Renton P, Ribon A, Riegler W, Rimondi F, Ristori L, Riveline M, Robertson WJ, Rodrigo T, Rolli S, Rosenson L, Roser R, Rossin R, Rott C, Roy A, Ruiz A, Safonov A, St Denis R, Sakumoto WK, Saltzberg D, Sanchez C, Sansoni A, Santi L, Sato H, Savard P, Savoy-Navarro A, Schlabach P, Schmidt EE, Schmidt MP, Schmitt M, Scodellaro L, Scott A, Scribano A, Sedov A, Segler S, Seidel S, Seiya Y, Semenov A, Semeria F, Shah T, Shapiro MD, Shepard PF, Shibayama T, Shimojima M, Shochet M, Sidoti A, Siegrist J, Sill A, Sinervo P, Singh P, Slaughter AJ, Sliwa K, Smith C, Snider FD, Solodsky A, Spalding J, Speer T, Sphicas P, Spinella F, Spiropulu M, Spiegel L, Steele J, Stefanini A, Strologas J, Strumia F, Stuart D, Sumorok K, Suzuki T, Takano T, Takashima R, Takikawa K, Tamburello P, Tanaka M, Tannenbaum B, Tecchio M, Tesarek RJ, Teng PK, Terashi K, Tether S, Thompson AS, Thomson E, Thurman-Keup R, Tipton P, Tkaczyk S, Toback D, Tollefson K, Tollestrup A, Tonelli D, Toyoda H, Trischuk W, de Troconiz JF, Tseng J, Tsybychev D, Turini N, Ukegawa F, Vaiciulis T, Valls J, Vataga E, Vejcik S 3rd, Velev G, Veramendi G, Vidal R, Vila I, Vilar R, Volobouev I, von der Mey M, Vucinic D, Wagner RG, Wagner RL, Wallace NB, Wan Z, Wang C, Wang MJ, Wang SM, Ward B, Waschke S, Watanabe T, Waters D, Watts T, Webb R, Wenzel H, Wester WC 3rd, Wicklund AB, Wicklund E, Wilkes T, Williams HH, Wilson P, Winer BL, Winn D, Wolbers S, Wolinski D, Wolinski J, Wolinski S, Worm S, Wu X, Wyss J, Yao W, Yeh GP, Yeh P, Yoh J, Yosef C, Yoshida T, Yu I, Yu S, Yu Z, Zanetti A, Zetti F, Zucchelli S; CDF Collaboration.
AUTHOR'S ADDRESS: University of Florida, Gainesville, Florida 32611, USA.
ABSTRACT: We report on measurements of the Upsilon(1S), Upsilon(2S), and Upsilon(3S) differential cross sections (d(2)sigma/dp(T)dy)(/y/<0.4), as well as on the Upsilon(1S) polarization in p p macro collisions at square root of s = 1.8 TeV using a sample of 77+/-3 pb(-1) collected by the collider detector at Fermilab. The three resonances were reconstructed through the decay Upsilon-->mu(+)mu(-). The measured angular distribution of the muons in the Upsilon(1S) rest frame is consistent with unpolarized meson production.
[For anyone who might be stumped by the physics, Hugh Pritchard offered the following explanation on GASNet....
"The paper...concerned differential cross-sections of the upsilon particle. A differential cross-section is one measured in a solid angle, i.e., how many upsilon particles were observed in a particular solid angle after an interaction (think cone with its point at interaction site). This isn't so straightforward: An upsilon particle is a very short-lived sub-atomic particle, a meson. A meson is intermediate in mass between an electron and a proton; and is always composed of a quark and its anti-quark. Mesons are subject to the strong force (compare the other 3 forces: weak, gravitational, and electromagnetic). Quarks are the theoretical smallest particles, with fractional masses ( +/- 1/3 or 2/3) combining to give, say, +1 for a proton. There are 6 "colors" of quark: up, down, strange, charmed, bottom (sometimes called beauty), and top (sometimes called truth). An upsilon meson is composed of a bottom quark and an anti-bottom quark."]