MB's Articles of Interest - December 2002

ARTICLE TITLE: An evidence-based review on the use of corticosteroids in peri-operative and critical care
ARTICLE SOURCE: Acta Anaesthesiol Sin (China ( Republic:1949-)), Jun 2002, 40(2) p71-9
AUTHOR(S): Han YY; Sun WZ
AUTHOR'S ADDRESS: Department of Anesthesiology, National Taiwan University, College of Medicine and Hospital, Taipei, Taiwan, R.O.C.
PUBLICATION TYPE: Journal Article
ABSTRACT:. A survey conducted to define the role of corticosteroids in various settings of peri-operative and critical care gave strong evidence to support that the use of corticosteroid is absolutely indicated in patients with adrenal insufficiency, asthma, anaphylaxis, acute spinal cord injury, and increased ICP resulting from brain tumors. As the benefits of corticosteroids are much in evidence, their uses are recommended to extend to postoperative antiemesis, acute respiratory failure (such as ARDS, COPD, and fat embolism), increased ICP associated with brain abscess, thyroid storm, and refractory hypothermia. Beneficial effect could be expected in septic shock with high-dose corticosteroids. Despite extensive reports on their versatile usefulness, evidence-based review did not recommend the use of corticosteroids in increased ICP associated with traumatic head injury and cerebral infarct, cardiac arrest, post-extubation airway edema, and aspiration pneumonia due to poor effectiveness let alone further worsening of the conditions. Great caution must be taken in clinical situations where administration of corticosteroids is considered contraindicated such as systemic fungal infection, hypersensitivity to the drug, intramuscular injection in idiopathic thrombocytopenia purpura, vaccination with live virus.

ARTICLE TITLE: Accessibility to coronary angiography and one-year survival after myocardial infarction.
ARTICLE SOURCE: Am J Cardiol (United States), Aug 15 2002, 90(4) p409
AUTHOR(S): Aros F; Marrugat J; Lopez-Bescos L; Cabades A; Loma-Osorio A; Bosch X
AUTHOR'S ADDRESS: Cardiologia, Hospital Txagorritxu, Vitoria, Spain.
PUBLICATION TYPE Journal Article
MB: 168 hospitals in Spain. The immediate & 1 year prognosis were similar independent of having cardiac catheter facilities.

ARTICLE TITLE: Usefulness of standard electrocardiographic parameters for predicting cardiac events after acute myocardial infarction during modern treatment era.
ARTICLE SOURCE: Am J Cardiol (United States), Aug 1 2002, 90(3) p205-9
AUTHOR(S): Perkiomaki JS; Zareba W; Greenberg HM; Moss AJ
AUTHOR'S ADDRESS: Cardiology Unit, Department of Medicine, University of Rochester School of Medicine and Dentistry, New York 14642, USA; Collective Name: Thrombogenic Factors and Recurrent Coronary Events Investigators.
PUBLICATION TYPE: Journal Article
In conclusion, lateral ST depression and atrial abnormality on the electrocardiogram are independent predictors of cardiac death after AMI. Lateral ST depression is also associated with ischemic cardiac events.

ARTICLE TITLE: Electrocardiographic observations in professional football players.
ARTICLE SOURCE: Am J Cardiol (United States), Jul 15 2002, 90(2) p198-200
AUTHOR(S): Choo JK; Abernethy WB; Hutter AM
AUTHOR'S ADDRESS: Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
PUBLICATION TYPE: Journal Article
In summary, abnormal electrocardiograms are common in American professional football players: early repolarization and ST and T-wave abnormalities are more common in black players; intraventricular conduction delays are more common in white players.
MB: Football is bad.

ARTICLE TITLE: Comparison of coronary artery bypass grafting versus medical therapy on long-term outcome in patients with ischemic cardiomyopathy (a 25-year experience from the Duke Cardiovascular Disease Databank).
ARTICLE SOURCE: Am J Cardiol (United States), Jul 15 2002, 90(2) p101-7
AUTHOR(S): O'Connor CM; Velazquez EJ; Gardner LH; Smith PK; Newman MF; Landolfo KP; Lee KL; Califf RM; Jones RH
AUTHOR'S ADDRESS: Division of Cardiology, Department of Medicine, Duke University Medical Center and Duke Clinical Research Institute, Durham, North Carolina 27715, USA.
PUBLICATION TYPE: Journal Article
Unadjusted, event-free, and adjusted survival strongly favored CABG over medical therapy after 30 days to >10 years regardless of the extent of coronary disease (p <0.001). Thus, regardless of the severity of coronary disease, heart failure symptoms, or ventricular dysfunction, CABG provides extended event-free and survival advantage over medical therapy alone in patients with an ischemic cardiomyopathy.

ARTICLE TITLE: Is it time to reassess the optimal timing of coronary artery bypass graft surgery following acute myocardial infarction?
COMMENTS: Comment On: Comment On: RefSource:Am J Cardiol. 2002 Jul 1; 90(1):1-4
ARTICLE SOURCE: Am J Cardiol (United States), Jul 1 2002, 90(1) p35-8
AUTHOR(S): Boden WE
PUBLICATION TYPE: Comment; Editorial
RECOMMENDATIONS. For patients who have AMI associated with cardiogenic shock or severe left ventricular failure, particularly if there is an associatedmechanical lesion such as rupture of the interventricular septum, papillary muscle rupture or dysfunction, or continuing myocardial ischemia that is unresponsive to maximum medical therapy, urgent operation may be life-saving, but is clearly high-risk.
<snip>Although the results of the Zaroff et al study do not settle the issue of whether post-AMI patients should undergo CABG as part of theAMI admission versus elective readmission for CABG during the recovery phase post-AMI, this report provides important, relevant, and useful information that may facilitate clinical decision-making, improve risk stratification, and enhance clinical outcomes.

ARTICLE TITLE: Effect of metoprolol on absolute myocardial blood flow in patients with heart failure secondary to ischemic or nonischemic cardiomyopathy.
ARTICLE SOURCE: Am J Cardiol (United States), Jun 15 2002, 89(12) p1431-4
AUTHOR(S): Bennett SK; Smith MF; Gottlieb SS; Fisher ML; Bacharach SL; Dilsizian V
AUTHOR'S ADDRESS: Division of Nuclear Medicine and Cardiology, The University of Maryland Medical Center and School of Medicine, Baltimore, Maryland 21201-1595, USA.
PUBLICATION TYPE: Journal Article
In summary, these data indicate that in patients with ischemic cardiomyopathy, improvement in global LV function during metoprolol therapy may be attributed, in part, to redistribution in absolute myccardial blood flow, resulting in increases in regional left ventriclar function. However, it appears that other mechanisms of action are keys to improvement in LV function seen in patients with nonischemic cardiomyopathy.

ARTICLE TITLE: One-year outcome after combined coronary artery bypass grafting and transmyocardial laser revascularization for refractory angina pectoris.
ARTICLE SOURCE: Am J Cardiol (United States), Jun 15 2002, 89(12) p1365-8
AUTHOR(S): Stamou SC; Boyce SW; Cooke RH; Carlos BD; Sweet LC; Corso PJ
AUTHOR'S ADDRESS: Section of Cardiac Surgery, Washington Hospital Center, Washington, DC 20010, USA.
PUBLICATION TYPE: Journal Article
Thus, procedural success at 30 days and overall event-free and actuarial survival in a high-risk population setting shows that coronary artery bypass graft surgery (CABG) plus transmyocardial revascularization (TMR) is a safe revascularization option for patients with intractable angina pectoris.

ARTICLE TITLE: Statins and the soul of medicine.
ARTICLE SOURCE: Am J Cardiol (United States), Jun 1 2002, 89(11) p1286-90
AUTHOR(S): Ornish D
PUBLICATION TYPE: Editorial
In summary, statin drugs have many therapeutic benefits and represent a breakthrough in treating and helping to prevent coronary heart disease. However, the need for these drugs can be significantly reduced and, in some cases, eliminated by making more comprehensive changes in diet and lifestyle than the new NCEP ATP III guidelines recommend. This therapeutic option should be offered to all patients with the support to make and maintain these comprehensive lifestyle changes. Patients who are not interested in making changes in diet and lifestyle to this degree should be prescribed statin drugs.

ARTICLE TITLE: Effectiveness of three models for comprehensive cardiovascular disease risk reduction.
ARTICLE SOURCE: Am J Cardiol (United States), Jun 1 2002, 89(11) p1263-8
AUTHOR(S): Gordon NF; English CD; Contractor AS; Salmon RD; Leighton RF; Franklin BA; Haskell WL
AUTHOR'S ADDRESS: Center for Heart Disease Prevention, St. Joseph's/Candler Health System, Savannah, Georgia 31405, USA. ngordon@interventusa.com.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
For patients with a baseline maximal oxygen uptake < 7 metabolic equivalents, cardiorespiratory fitness increased to a greater degree in patients in the cardiac rehabilitation program and the community-based program versus the physician-supervised, nurse- case-managed program. These data have important implications for cost containment and increasing accessibility to clinically effective comprehensive cardiovascular risk reduction services in low- or moderate-risk patients with coronary artery disease (CAD).

ARTICLE TITLE: Incidence of new coronary events in older persons with prior myocardial infarction and systemic hypertension treated with beta blockers, angiotensin-converting enzyme inhibitors, diuretics, calcium antagonists, and alpha blockers.
ARTICLE SOURCE: Am J Cardiol (United States), May 15 2002, 89(10) p1207-9
AUTHOR(S): Aronow WS; Ahn C
AUTHOR'S ADDRESS: Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, New York, USA. WSAronow@aol.com.
PUBLICATION TYPE: Journal Article
Beta blockers and ACE inhibitors were the most effective antihypertensive drugs in reducing the incidence of new coronary events in older patients with prior myocardial infarction and systemic hypertension.

ARTICLE TITLE: Postoperative ventricular function and cardiac enzymes after on-pump versus off-pump CABG surgery.
ARTICLE SOURCE: Am J Cardiol (United States), May 1 2002, 89(9) p1107-10
AUTHOR(S): Chang PP; Sussman MS; Conte JV; Grega MA; Schulman SP; Gerstenblith G; Wang NY; Capriotti A; Weiss JL
AUTHOR'S ADDRESS: Department of From the Departments of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. pchang@jhmi.edu.
PUBLICATION TYPE: Clinical Trial; Journal Article
CABG performed on cardiopulmonary bypass compared with off-pump CABG is associated with earlier postoperative LV dysfunction and a higher and steeper cardiac enzyme increase, suggesting greater perioperative ischemic injury in this group. The extent of immediate postoperative LV dysfunction did not correlate with the extent of enzyme increase in either group, suggesting that the pathophysiologic mechanism for these 2 outcome measures differs.

ARTICLE TITLE: The thrower's shoulder Part I: diagnosis and early treatment
ARTICLE SOURCE: Am J Orthop (United States), May 2002, 31(5) p297-304
AUTHOR(S): Dugas JR; Crockett MH; Eaton K; Paletta GA; Timmerman L
AUTHOR'S ADDRESS: Alabama Sports Medicine and Orthopaedic Center and American Sports Medicine Institute, Birmingham, USA.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: The thrower's shoulder. Part II: a surgical discussion
ARTICLE SOURCE: Am J Orthop (United States), Jun 2002, 31(6) p356-64
AUTHOR(S): Dugas JR; Crockett HC; Eaton K; Paletta GA; Timmerman L
AUTHOR'S ADDRESS: Alabama Sports Medicine and Orthopaedic Center, Birmingham, USA.
PUBLICATION TYPE: Journal Article
MB: All these abnormal activities are damaging. Why does the common view encourage them.

ARTICLE TITLE: The resident as a working stiff
ARTICLE SOURCE: Am J Orthop (United States), Jun 2002, 31(6) p316
AUTHOR(S): Gould JS
PUBLICATION TYPE: Editorial

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
The records of 354 consecutive patients undergoing total hip arthroplasty (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.
MB: It's peculiar that they seem to think that some compulsion determines if blood is given. The factors might alter the anaesthetist's decision if they reduced the ability to tolerate physiological insults particularly the quantity of blood loss.

ARTICLE TITLE: Blood transfusions correlate with infections in trauma patients in a dose-dependent manner.
ARTICLE SOURCE: Am Surg (United States), Jul 2002, 68(7) p566-72
AUTHOR(S): Claridge JA; Sawyer RG; Schulman AM; McLemore EC; Young JS
AUTHOR'S ADDRESS: Department of Surgery, University of Virginia Health System, Charlottesville 22908-0709, USA.
PUBLICATION TYPE: Journal Article
In summary there is a clear dose-dependent correlation between transfusions of pRBCs and the development of infection in trauma patients. Multivariate analysis further demonstrated that packed red blood cells (pRBCs) were an independent risk factor for the development of infections. Although transfusions are frequently indicated, they should be administered appropriately and with no more pRBCs than absolutely necessary.
MB: Pretty silly advice. Those with bigger operations would be more likely to get both blood transfusions and infections.

ARTICLE TITLE: Magnesium as first line therapy in the management of tetanus: a prospective study of 40 patients
ARTICLE SOURCE: Anaesthesia (England), Aug 2002, 57(8) p778-817
AUTHOR(S): Attygalle D; Rodrigo N
PUBLICATION TYPE: Journal Article
We recommend magnesium as possible first line therapy in the routine management of tetanus.
MB: In Sri Lanka. 40 cases over 4 years. 12% mortality. I visited a big tetanus unit in Bombay, India in 1968 while returning from Viet Nam. They were noted for treating tetanus with diazepam with which we had had only limited success. I asked them what they would use on a doctor's child. They said curare.

ARTICLE TITLE: The effect of dexamethasone upon patient-controlled analgesia-related nausea and vomiting.
ARTICLE SOURCE: Anaesthesia (England), Jul 2002, 57(7) p705-9
AUTHOR(S): Lee Y; Lin YS; Chen YH
AUTHOR'S ADDRESS: Department of Anaesthesiology, Tzu-Chi Medical Center, Tsu-Chi University School of Medicine, No. 707 Section 3, Chung-Yang Road, Hualien, Taiwan, Rebublic of China. drleeyi@sinamail.com.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
We conclude that dexamethasone 8 mg may be valuable for preventing patient-controlled analgesia-related nausea and vomiting in women undergoing major orthopaedic surgery.
MB: I don't think it's a good idea to give steroids for something as trivial as PONV. Many other things could be used. Wasn't thalidomide used for morning sickness?

ARTICLE TITLE: Use of the common gas outlet for the administration of supplemental oxygen during Caesarean section under regional anaesthesia.
ARTICLE SOURCE: Anaesthesia (England), Jul 2002, 57(7) p690-2
AUTHOR(S): Stone AG; Howell PR
AUTHOR'S ADDRESS: Bart's and the London School of Anaesthesia, Royal London Hospital, London E1 1BB, UK.
PUBLICATION TYPE: Journal Article
ABSTRACT: A postal survey investigating the administration of supplemental oxygen to women undergoing Caesarean section under regional anaesthesia was sent to 262 lead consultant obstetric anaesthetists in the UK. Two hundred and fifteen (82) completed questionnaires were returned. In 139 units (65) supplemental oxygen was administered routinely to all Caesarean sections under regional techniques, while in 71 (33), supplemental oxygen was given only if the procedure is an emergency or if there was evidence of fetal or maternal compromise. In 196 units (91), the common gas outlet was used as the source of supplemental oxygen, with the standard anaesthetic breathing circuit disconnected in 194 (90) and the vaporisers left on the back bar in 191 (89). Critical incidents had occurred in 39 (18) of units using the common gas outlet as a source of supplemental oxygen and 63 (30) had experience of critical incidents with this practice in a non-obstetric setting. We suggest that supplemental oxygen is more safely administered from a separate and dedicated source.
MB: This is a typical 'system problem' known to exist by many people but not fixed by the system or any member of the system. The problem has been reported before.
We had a death. We immediately fitted dedicated supplemental oxygen outlets on all our anaesthesia machines. We did not publish our incident or make any moves to have our solution standardised even after a near miss was published.

ARTICLE TITLE: Prediction by computerised tomography of distance from skin to epidural space during thoracic epidural insertion.
ARTICLE SOURCE: Anaesthesia (England), Jul 2002, 57(7) p701-4
AUTHOR(S): Carnie J; Boden J; Gao Smith F
AUTHOR'S ADDRESS: Department of Anaesthesia, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK. CarnieJ@heartsol.wmids.nhs.uk.
PUBLICATION TYPE: Evaluation Studies; Journal Article
The mean (95% CI) difference between CT-derived and actual depths was 0.26 (0.03-0.49) cm. Thus, the CT-derived depth tends to be greater than the actual depth by between 0.03 and 0.49 cm.

ARTICLE TITLE: The effects of hypertonic saline solution (7.5%) on coagulation and fibrinolysis: an in vitro assessment using thromboelastography.
ARTICLE SOURCE: Anaesthesia (England), Jul 2002, 57(7) p644-8
AUTHOR(S): Tan TS; Tan KH; Ng HP; Loh MW
AUTHOR'S ADDRESS: Department of Anaesthesia, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.
PUBLICATION TYPE: Journal Article
ABSTRACT: We studied the effects of hypertonic (7.5%) and normal saline on coagulation and fibrinolysis in an in vitro model using thromboelastography of human whole blood. <snip> We conclude that 7.5% hypertonic saline solution has anticoagulant effects if it replaces 7.5% or more of blood volume.
MB: The TEG is not independently calibrated.

ARTICLE TITLE: Aseptic precautions for inserting an epidural catheter: a survey of obstetric anaesthetists.
ARTICLE SOURCE: Anaesthesia (England), Jun 2002, 57(6) p593-6
AUTHOR(S): Sellors JE; Cyna AM; Simmons SW
AUTHOR'S ADDRESS: Department of Obstetric Anaesthesia, Women and Children's Hospital, Adelaide, SA, Australia.
PUBLICATION TYPE: Journal Article
ABSTRACT: We performed a postal survey of Fellows of the Australian and New Zealand College of Anaesthetists with a special interest in obstetric practice, about their beliefs regarding aseptic precautions for insertion of an epidural catheter in the labour ward. Of the 435 consultant anaesthetists surveyed, 367 responded (84%), revealing a wide variation in practice. It was not thought to be essential practice to remove a watch before washing hands by 51 respondents (14%), to wear a facemask by 105 (29%) or to wear a sterile gown by 45 (12%). Three anaesthetists (1%) did not believe sterile gloves were essential. However, all respondents indicated that an antiseptic skin preparation was essential. Our results raise questions regarding an acceptable standard of aseptic practice for the insertion of an epidural catheter in labour and we propose a minimal standard of essential precautions.
MB: There was a very public death from an epidural abscess in Sydney recently. This survey is a good example of unregulated belief based medicine.

ARTICLE TITLE: Pulmonary artery blood temperature and the measurement of cardiac output by thermodilution.
ARTICLE SOURCE: Anaesthesia (England), Jun 2002, 57(6) p562-6
AUTHOR(S): Moise SF; Sinclair CJ; Scott DH
AUTHOR'S ADDRESS: Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3 9YW, UK. SMoise20@AOL.com.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
ABSTRACT: Thermodilution cardiac output measurement assumes that the temperature within the pulmonary artery is stable during the measurement period. This may not be achieved in clinical practice because of temperature changes that are not solely produced by the thermal indicator. Such temperature changes constitute thermal noise. Thermal noise and how it may interfere with measurement is discussed with reference to both the injectate and the thermal filament methods of thermodilution cardiac output measurement.

ARTICLE TITLE: Awareness during general anaesthesia: a review of 81 cases from the Anaesthetic Incident Monitoring Study.
ARTICLE SOURCE: Anaesthesia (England), Jun 2002, 57(6) p549-56
AUTHOR(S): Bergman IJ; Kluger MT; Short TG
AUTHOR'S ADDRESS: Department of Anaesthesia, Auckland Hospital, Auckland, New Zealand.
PUBLICATION TYPE: Journal Article
ABSTRACT: Because of recent studies suggesting that awareness is still a major issue in anaesthetic practice, we reviewed 8372 incidents reported to the Anaesthetic Incident Monitoring Study. There were 81 cases in which peri-operative recall was consistent with awareness. There were 50 cases of definite awareness and 31 cases with a high probability of awareness. In 13 of the 81 incidents, the patients appeared to receive adequate doses of anaesthetic drugs. Where the cause could be determined, awareness was mainly due to drug error resulting in inadvertent paralysis of an awake patient (n = 32) and failure of delivery of volatile anaesthetic (n = 16). Less common causes included prolonged attempts at intubation of the trachea (n = 5), deliberate withdrawal of volatile anaesthetic (n = 4) or muscle relaxant apnoea with inadequate administration of hypnotic (n = 3). An objective central nervous system depth of anaesthesia monitor may have prevented 42 of these incidents and an improved drug administration system may have prevented 32. On the basis of these reports, we have developed guidelines that may have prevented the majority of these incidents.
MB: Most of the literature implies that awareness is inevitable & unpredictable. As these cases are self reported it must be assumed that some did not notice or report causal factors.

ARTICLE TITLE: Weaning from mechanical ventilation in a neurologic disease: an unusual application for tracheal gas insufflation
ARTICLE SOURCE: Anesthesiology (United States), Aug 2002, 97(2) p515-7
AUTHOR(S): Ramesh VJ; Umamaheswara Rao GS
AUTHOR'S ADDRESS: Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences, Bangalore, India.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Successful treatment of delayed onset paraplegia after suprarenal abdominal aortic aneurysm repair
ARTICLE SOURCE: Anesthesiology (United States), Aug 2002, 97(2) p504-6
AUTHOR(S): Weiss SJ; Hogan MS; McGarvey ML; Carpenter JP; Cheung AT
AUTHOR'S ADDRESS: Departments of Anesthesiology, Neurology, and Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
PUBLICATION TYPE: Journal Article
MB: This recovery could have been spontaneous.

ARTICLE TITLE: Randomized Prospective Comparison of Forced Air Warming Using Hospital Blankets versus Commercial Blankets in Surgical Patients
ARTICLE SOURCE: Anesthesiology (United States), Aug 2002, 97(2) p338-44
AUTHOR(S): Kabbara A; Goldlust SA; Smith CE; Hagen JF; Pinchak AC
AUTHOR'S ADDRESS: Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
PUBLICATION TYPE: Journal Article
The majority of patients were satisfied with their anesthetic and warming technique: experimental, 38 of 39 patients; control, 44 of 44 patients. There were no thermal injuries. CONCLUSIONS: Standard hospital blankets heated to 38 degrees C forced air were equally as effective as commercial blankets heated with forced air at 43 degrees C. However, based on concerns expressed by the manufacturer, this experimental technique should not be used until further safety evaluation has been undertaken.
MB: Some still got objectively cold. How about applying blankets appropriately before getting to OR. What could patient satisfaction mean when some would not have been aware that anything special had been done.

ARTICLE TITLE: The influence of mild hypothermia on the pharmacokinetics and time course of action of neostigmine in anesthetized volunteers.
ARTICLE SOURCE: Anesthesiology (United States), Jul 2002, 97(1) p90-5
AUTHOR(S): Heier T; Clough D; Wright PM; Sharma ML; Sessler DI; Caldwell JE
AUTHOR'S ADDRESS: Department of Anesthesia and Perioperative Care, University of California, San Francisco, California 94143-0648, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The efficacy of neostigmine as an antagonist of vecuronium-induced neuromuscular block is not altered by mild hypothermia.

ARTICLE TITLE: Eliminating intensive postoperative care in same-day surgery patients using short-acting anesthetics.
ARTICLE SOURCE: Anesthesiology (United States), Jul 2002, 97(1) p66-74
AUTHOR(S): Apfelbaum JL; Walawander CA; Grasela TH; Wise P; McLeskey C; Roizen MF; Wetchler BV; Korttila K
AUTHOR'S ADDRESS: Department of Anesthesia and Critical Care, University of Chicago Hospitals and Clinics, Illinois, 60637, USA. jeffa@airway.uchicago.edu.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Sevoflurane but not propofol preserves myocardial function in coronary surgery patients.
ARTICLE SOURCE: Anesthesiology (United States), Jul 2002, 97(1) p42-9
AUTHOR(S): De Hert SG; ten Broecke PW; Mertens E; Van Sommeren EW; De Blier IG; Stockman BA; Rodrigus IE
AUTHOR'S ADDRESS: Department of Anesthesiology, University Hospital Antwerp, Edegem, Belgium. sdehert@uia.ac.be.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: Sevoflurane preserved left ventricular (LV) function after cardiopulmonary bypass (CPB) with less evidence of myocardial damage in the first 36 h postoperatively. These data suggest a cardioprotective effect of sevoflurane during coronary artery surgery.
MB: Why does it not mean that propofol is damaging?

ARTICLE TITLE: Editorial view: anesthetic preconditioning: serendipity and science.
ARTICLE SOURCE: Anesthesiology (United States), Jul 2002, 97(1) p1-3
AUTHOR(S): Warltier DC; Kersten JR; Pagel PS; Gross GJ
PUBLICATION TYPE: Editorial
MB: Suggesting that inhalational agents might protect the heart rather than the more obvious suggestion that the IV agents might be damaging the heart but that inhalational agents do not. It is difficult to give an over dose with inhalational agents & can be easily corrected. Is it really necessary to invent a new concept?

ARTICLE TITLE: Propofol induced marked prolongation of QT interval in a patient with acute myocardial infarction.
ARTICLE SOURCE: Anesthesiology (United States), Jul 2002, 97(1) p265-6
AUTHOR(S): Sakabe M; Fujiki A; Inoue H
AUTHOR'S ADDRESS: Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Sugitani, Toyama, Japan.
PUBLICATION TYPE: Journal Article
MB: They started with 1.4 mg/kg in a patient with an acute infarct. You can't be sure what happened.

ARTICLE TITLE: Anaphylactic shock due to suxamethonium complicated by a coronary thrombus.
ARTICLE SOURCE: Anesthesiology (United States), Jul 2002, 97(1) p269-71
AUTHOR(S): Joly V; Ceddaha A; Guinnepain MT; Makowski S; Henry P; Fischler M
AUTHOR'S ADDRESS: Department of Anesthesiology, Hopital Foch, Universite Paris-Ouest, Suresnes, France.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: The invention and development of blood gas analysis apparatus.
ARTICLE SOURCE: Anesthesiology (United States), Jul 2002, 97(1) p253-6
AUTHOR(S): Severinghaus JW
AUTHOR'S ADDRESS: Department of Anesthesiology, University of California Medical School, San Francisco, California 94143-0542, USA. jwseps@attbi.com.
PUBLICATION TYPE: Journal Article
MB: The inventor's account.

ARTICLE TITLE: Impact of unplanned extubation and reintubation after weaning on nosocomial pneumonia risk in the intensive care unit: a prospective multicenter study.
ARTICLE SOURCE: Anesthesiology (United States), Jul 2002, 97(1) p148-56
AUTHOR(S): de Lassence A; Alberti C; Azoulay E; Le Miere E; Cheval C; Vincent F; Cohen Y; Garrouste-Orgeas M; Adrie C; Troche G; Timsit JF
AUTHOR'S ADDRESS: Medical ICU, Avicenne Hospital, Bobigny, France. arnaud.de-lassence@outcomerea.org; Collective Name: OUTCOMEREA Study Group.
PUBLICATION TYPE: Journal Article
CONCLUSION: Accidental extubation but not self-extubation or reintubation after weaning increased the risk of nosocomial pneumonia. These 3 events may deserve evaluation as an indicator for quality-of-care studies.

ARTICLE TITLE: Anesthetic-related cardiac arrest and its mortality: a report covering 72,959 anesthetics over 10 years from a US teaching hospital.
ARTICLE SOURCE: Anesthesiology (United States), Jul 2002, 97(1) p108-15
AUTHOR(S): Newland MC; Ellis SJ; Lydiatt CA; Peters KR; Tinker JH; Romberger DJ; Ullrich FA; Anderson JR
AUTHOR'S ADDRESS: Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska 68198-4455, USA. mnewland@unmc.edu.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Most perioperative cardiac arrests were related to medication administration, airway management, and technical problems of central venous access. Improvements focused on these three areas may result in better outcomes.
MB: Let's hope so.

ARTICLE TITLE: Distribution of local anesthetic in axillary brachial plexus block: a clinical and magnetic resonance imaging study.
ARTICLE SOURCE: Anesthesiology (United States), Jun 2002, 96(6) p1315-24
AUTHOR(S): Klaastad O; Smedby O; Thompson GE; Tillung T; Hol PK; Rotnes JS; Brodal P; Breivik H; Hetland KR; Fosse ET
AUTHOR'S ADDRESS: Department of Anesthiology, Oslo Orthopedic University Hospital, Norway. oivind.klaastad@rikshospitalet.no.
PUBLICATION TYPE: Journal Article
CONCLUSION: This study demonstrated that magnetic resonance imaging (MRI) is useful in examining local anesthetic distribution in axillary blocks because it can show the correlation between MRI distribution pattern and clinical effect. The cross-sectional spread of fluid around the brachial-axillary artery was often incomplete-inhibited, and the clinical effect often inadequate.

ARTICLE TITLE: Influence of cardiac output on plasma propofol concentrations during constant infusion in swine.
ARTICLE SOURCE: Anesthesiology (United States), Jun 2002, 96(6) p1498-503
AUTHOR(S): Kurita T; Morita K; Kazama T; Sato S
AUTHOR'S ADDRESS: Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan. tadkur@hama-med.ac.jp.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: An inverse relation was observed between by cardiac output (CO) and propofol concentrations. The lungs appear to have a minor effect on plasma propofol concentrations during constant infusion in anesthetized swine.
MB: Doesn't it just mean that more propofol depresses the heart more.

ARTICLE TITLE: With technology comes responsibility: intraoperative failure of an anesthetic vaporizer.
ARTICLE SOURCE: Anesthesiology (United States), Jun 2002, 96(6) p1533-4; discussion 1534-5
AUTHOR(S): Kimatian SJ
PUBLICATION TYPE: Letter
MB: An incompatibility of a Drager Julian & a Datex/Ohmeda system

ARTICLE TITLE: Permanent paraparesis and cauda equina syndrome after epidural blood patch for postdural puncture headache.
ARTICLE SOURCE: Anesthesiology (United States), Jun 2002, 96(6) p1515-7
AUTHOR(S): Diaz JH
AUTHOR'S ADDRESS: Department of Anesthesiology, Louisiana State University Health Sciences Center and Multidisciplinary Pain Mastery Center, New Orleans, Louisiana 70112, USA. jdiaz@lsuhsc.edu.
PUBLICATION TYPE: Journal Article
MB: After a diagnostic LP. I am sure they won't do that again for a while.

ARTICLE TITLE: Patient-controlled regional analgesia (PCRA) at home: controlled comparison between bupivacaine and ropivacaine brachial plexus analgesia.
COMMENTS: Comment In: Comment In: RefSource:Anesthesiology. 2002 Jun; 96(6):1283-5
ARTICLE SOURCE: Anesthesiology (United States), Jun 2002, 96(6) p1290-6
AUTHOR(S): Rawal N; Allvin R; Axelsson K; Hallen J; Ekback G; Ohlsson T; Amilon A
AUTHOR'S ADDRESS: Department of Anesthesiology and Intensive Care, Orebro Medical Center Hospital, Orebro, Sweden. n.rawal@orebroll.se.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: This double-blinded study has demonstrated the feasibility of self-administration of local anesthetic to manage postoperative pain outside the hospital. Ropivacaine and bupivacaine provided effective analgesia, and patient satisfaction with patient-controlled regional analgesia (PCRA) was high. Patient selection, follow-up telephone call, and 24-h access to anesthesiology services are prerequisites for PCRA at home.
MB: Satisfaction rate was between 52% & 83%.

ARTICLE TITLE: Continuous infraclavicular brachial plexus block for postoperative pain control at home: a randomized, double-blinded, placebo-controlled study.
COMMENTS: Comment In: Comment In: RefSource:Anesthesiology. 2002 Jun; 96(6):1283-5
ARTICLE SOURCE: Anesthesiology (United States), Jun 2002, 96(6) p1297-304
AUTHOR(S): Ilfeld BM; Morey TE; Enneking FK
AUTHOR'S ADDRESS: Department of Anesthesiology and Orthopedics and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida 32610, USA.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSION: After moderately painful orthopedic surgery of the upper extremity, ropivacaine infusion using a portable, mechanical pump and an infraclavicular brachial plexus perineural catheter at home decreased pain, sleep disturbances, narcotic use and related side effects, and improved overall satisfaction.
MB: The controls had a placebo. They were given oral narcotics as well. Average satisfaction rating was 9.2 out of 10 for the study group & 5.8 for placebo.

ARTICLE TITLE: Beyond the hospital: continuous peripheral nerve blocks at home.
COMMENTS: Comment On: Comment On: RefSource:Anesthesiology. 2002 Jun; 96(6):1290-6; Comment On: Comment On: RefSource:Anesthesiology. 2002 Jun; 96(6):1297-304
ARTICLE SOURCE: Anesthesiology (United States), Jun 2002, 96(6) p1283-5
AUTHOR(S): Klein SM
PUBLICATION TYPE: Comment; Editorial
MB: You can do anything if you try hard enough. Neither of the 2 above studies tried parenteral narcotic which regularly gives 90% satisfaction.

ARTICLE TITLE: NO-body's perfect.
COMMENTS: Comment On: Comment On: RefSource:Anesthesiology. 2002 Jun; 96(6):1504-13
ARTICLE SOURCE: Anesthesiology (United States), Jun 2002, 96(6) p1285-7
AUTHOR(S): Hurford WE; Bigatello LM
PUBLICATION TYPE: Comment; Editorial
MB: It's about nitric oxide & the lungs. I wish bored editors would stop using cryptic titles for their editorials.

ARTICLE TITLE: Intraoperative use of recombinant activated coagulation factor VII.
COMMENTS: Comment On: Comment On: RefSource:Anesthesiology. 2002 Jun; 96(6):1522-5; Comment On: Comment On: RefSource:Anesthesiology. 2002 Jun; 96(6):1525-7; Comment On: Comment On: RefSource:Anesthesiology. 2002 Jun; 96(6):1528
ARTICLE SOURCE: Anesthesiology (United States), Jun 2002, 96(6) p1287-9
AUTHOR(S): Weiskopf RB
PUBLICATION TYPE: Comment; Editorial
MB: We have used the stuff in desperation in some liver transplants. It sometimes seemed to work. We are involved in a multi-centre trial in liver transplants. The editorial indicates that there is no established rational indications but that the desperate use can be justified.

ARTICLE TITLE: Medicolegal claims in vascular surgery.
ARTICLE SOURCE: Ann R Coll Surg Engl (England), May 2002, 84(3) p181-4
AUTHOR(S): Campbell WB; France F; Goodwin HM
AUTHOR'S ADDRESS: Vascular Surgical Society of Great Britain and Ireland, Royal College of Surgeons of England, London, UK; Collective Name: Research and Audit Committee of the Vascular Surgical Society of Great Britain and Ireland.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The likely cause of many of these claims was failure to advise patients about potential risks and expected benefits. Recognition of the areas of highest risk, with improvements in communication and record keeping, may limit future claims.
MB: In NSW there were a lot of cases where ischaemia of lower limbs were not noticed because of epidurals. In Victoria more than half of payouts for anaesthesia/analgesia are for epidurals.

ARTICLE TITLE: Rubber band ligation of haemorrhoids in the out-patient clinic.
ARTICLE SOURCE: Ann R Coll Surg Engl (England), May 2002, 84(3) p172-4
AUTHOR(S): Kumar N; Paulvannan S; Billings PJ
AUTHOR'S ADDRESS: Department of Surgery, Wrexham Maelor Hospital, UK. nkumar1402@hotmail.com.
PUBLICATION TYPE: Journal Article
Symptomatic cure was achieved in 71 patients (72.4%). Rubber band ligation (RBL) is an effective treatment but with significant complications. Patients should be adequately warned, especially of pain and vasovagal attacks.

ARTICLE TITLE: Peri-operative fluid and electrolyte management: a survey of consultant surgeons in the UK.
ARTICLE SOURCE: Ann R Coll Surg Engl (England), May 2002, 84(3) p156-60
AUTHOR(S): Lobo DN; Dube MG; Neal KR; Allison SP; Rowlands BJ
AUTHOR'S ADDRESS: Section of Surgery, University Hospital, Queen's Medical Centre, Nottingham, UK. dileep.lobo@nottingham.ac.uk.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Consultant surgeons feel that present practice in peri-operative fluid management is unsatisfactory. Higher standards within clinical governance and risk management may be achieved by focused practical training combined with formal written guidelines.
MB: No wonder they are having trouble with governance in the NHS. Those consultants should consider themselves responsible. That is what they are paid for. It was probably a mistake to have called them consultants rather than specialists when the NHS started in 1948. The classical consultant consulted with the GP who continued to deal with the patient. We use the term staff specialist rather than staff consultant.

ARTICLE TITLE: Neurological outcomes in coronary surgery: independent effect of avoiding cardiopulmonary bypass
ARTICLE SOURCE: Ann Thorac Surg (United States), Aug 2002, 74(2) p400-5; discussion 405-6
AUTHOR(S): Patel NC; Deodhar AP; Grayson AD; Pullan DM; Keenan DJ; Hasan R; Fabri BM
AUTHOR'S ADDRESS: Department of Cardiothoracic Surgery, The Cardiothoracic Centre-Liverpool, United Kingdom.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Off-pump operation, with or without aortic manipulation, reduces adverse neurologic outcomes compared with on-pump procedures.

ARTICLE TITLE: Stroke after conventional versus minimally invasive coronary artery bypass
ARTICLE SOURCE: Ann Thorac Surg (United States), Aug 2002, 74(2) p394-9
AUTHOR(S): Stamou SC; Jablonski KA; Pfister AJ; Hill PC; Dullum MK; Bafi AS; Boyce SW; Petro KR; Corso PJ
AUTHOR'S ADDRESS: Department of Surgery, Washington Hospital Center, and MedStar Research Institute, DC 20010, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Off-pump cardiopulmonary bypass avoids the risks of cardiopulmonary bypass and atrial trauma. A substantially lower stroke rate suggests that an off-pump cardiopulmonary bypass (OPCAB) is a neurologically safe treatment option for revascularization.

ARTICLE TITLE: Cardiac surgery in moderate to end-stage renal failure: analysis of risk factors
ARTICLE SOURCE: Ann Thorac Surg (United States), Aug 2002, 74(2) p378-83
AUTHOR(S): Penta de Peppo A; Nardi P; De Paulis R; Pellegrino A; Forlani S; Scafuri A; Chiariello L
AUTHOR'S ADDRESS: Department of Cardiac Surgery, Tor Vergata University of Rome, Italy.
PUBLICATION TYPE: Journal Article
ABSTRACT: BACKGROUND: The incremental surgical risk caused by different categories of renal failure is not well defined.

ARTICLE TITLE: The influence of perioperative blood transfusion on survival after esophageal resection for carcinoma.
ARTICLE SOURCE: Ann Thorac Surg (United States), Jun 2002, 73(6) p1704-9
AUTHOR(S): Langley SM; Alexiou C; Bailey DH; Weeden DF
AUTHOR'S ADDRESS: Department of Cardiothoracic Surgery, Southampton General Hospital, Hampshire, United Kingdom. stephenlangley@dial.pipex.com.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: In addition to reaffirming the importance of completeness of resection and nodal involvement, this study demonstrates that blood transfusion (more than 3 units) may have a significant adverse effect on late survival after esophageal resection for carcinoma. Every effort should be made to limit the amount of transfused blood to the absolutely essential requirements.
MB: The surgeon causes the blood loss which is the only determinant of the quantity of transfused blood. The association of greater blood transfusion with worse late survival does not show causation. The factors determining worse late survival probably cause the greater blood loss.

ARTICLE TITLE: Abdominal aortic aneurysms: which surgeon and what procedure?
ARTICLE SOURCE: ANZ J Surg (Australia), Jun 2002, 72(6) p383-4
AUTHOR(S): Mellick S
PUBLICATION TYPE: Editorial
MB: Encourages the use of exclusively vascular surgeons and predicts that endoluminals should become the preferred method. Where I am this is already the case.

ARTICLE TITLE: Influence of preoperative medical status and delay to surgery on death following a hip fracture
ARTICLE SOURCE: ANZ J Surg (Australia), Jun 2002, 72(6) p405-7
AUTHOR(S): Stoddart J; Horne G; Devane P
AUTHOR'S ADDRESS: Department of Surgery, Wellington School of Medicine, Wellington South, New Zealand.
PUBLICATION TYPE: Journal Article
CONCLUSION: Time to surgery did not significantly affect 1-year mortality within each ASA Class.

ARTICLE TITLE: Myths surrounding bile duct injury
ARTICLE SOURCE: ANZ J Surg (Australia), Feb 2002, 72(2) p79-80
AUTHOR(S): Cuschieri A
PUBLICATION TYPE: Editorial
MB: Reviewing videos of laprascopic gall bladders when the bile ducts had been damaged revealed errors which could have been avoided.

ARTICLE TITLE: Airway fire during formation of tracheostomy
ARTICLE SOURCE: ANZ J Surg (Australia), Feb 2002, 72(2) p157-8
AUTHOR(S): Wheatley TJ; Maddern GJ
AUTHOR'S ADDRESS: University of Adelaide, Department of Surgery, The Queen Elizabeth Hospital, South Australia, Australia.
PUBLICATION TYPE: Journal Article
MB: It's difficult to work out what they did wrong from the report.

ARTICLE TITLE: Surgical undergraduate education in rural Australia.
ARTICLE SOURCE: Arch Surg (United States), Jul 2002, 137(7) p794-8
AUTHOR(S): Bruening MH; Maddern GJ
AUTHOR'S ADDRESS: Department of Surgery, University of Adelaide, Queen Elizabeth Hospital, Woodville Road, Woodville 5011, Adelaide, South Australia.
PUBLICATION TYPE: Journal Article
ABSTRACT: HYPOTHESIS: Surgical undergraduate education in a rural setting is feasible and sound in terms of educational outcomes. DESIGN: The final-year surgical curriculum at the University of Adelaide, Adelaide, South Australia, was restructured to include the option of a rural surgical term. SETTING: Five provincial center hospitals in rural South Australia. INTERVENTIONS: Forty-three final-year medical students undertook rural surgical clerkships in 1998. MAIN OUTCOME MEASURES: End-of-year results and subjective ward assessments were compared between the group of students who completed rural surgical terms and the remainder of the student group who participated in tertiary hospital-based electives. Subjective student feedback was obtained in a survey conducted by the Clinical Education Development Unit at the University of Adelaide. RESULTS: No significant (P =.45) differences in examination results were noted between the rural and city groups. A significant (P<.01) finding was observed in the subjective assessments, indicating that it was more difficult for the rural group to obtain an A grade compared with the city group. The rural students ranked the level of teaching and supervision highly and enjoyed the overall rural experience. CONCLUSION: Surgical undergraduate education is practical in a rural setting and, for educational outcome, seems to be at least as effective as city-based surgical clerkships in preparing students for final examinations.
MB: The criteria of success are performance in assessments.

ARTICLE TITLE: Research in medical education: three decades of progress.
ARTICLE SOURCE: BMJ (England), Jun 29 2002, 324(7353) p1560-2
AUTHOR(S): Norman G
AUTHOR'S ADDRESS: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada L8N 3Z5. norman@mcmaster.ca.
PUBLICATION TYPE: Historical Article; Journal Article
MB: It's worth looking at the full text as it is full of wishful thought & no supporting evidence

ARTICLE TITLE: Eating meat more than 10 times a week almost doubles chances of bowel cancer.
ARTICLE SOURCE: BMJ (England), Jun 29 2002, 324(7353) p1544
AUTHOR(S): Sweet M
PUBLICATION TYPE: News

ARTICLE TITLE: Harm from smoking is even greater than previously thought.
ARTICLE SOURCE: BMJ (England), Jun 29 2002, 324(7353) p1544
AUTHOR(S): Dyer O
PUBLICATION TYPE: News

ARTICLE TITLE: Australia: federal government subsidises long term care by up to 22,000 pounds sterling a year.
ARTICLE SOURCE: BMJ (England), Jun 29 2002, 324(7353) p1543
AUTHOR(S): Zinn C
PUBLICATION TYPE: News .

ARTICLE TITLE: beta Blockers protect brain during cardiac surgery.
ARTICLE SOURCE: BMJ (England), Jun 22 2002, 324(7352) p1475
AUTHOR(S): Tanne JH
PUBLICATION TYPE: News
MB: They halve the stroke rate.

ARTICLE TITLE: Diagnosing brain death without a neurologist.
ARTICLE SOURCE: BMJ (England), Jun 22 2002, 324(7352) p1471-2
AUTHOR(S): Baumgartner H; Gerstenbrand F
PUBLICATION TYPE: Editorial
MB: We have neurologists. They are worried about places where they think there are intensivists but no neurolgists. I think that it would be uncommon to have intensive care able to keep brain dead subjects going with no neurologists around.

ARTICLE TITLE: US government supports Maine law to curb drug prices.
ARTICLE SOURCE: BMJ (England), Jun 15 2002, 324(7351) p1416
AUTHOR(S): Josefson D
PUBLICATION TYPE: News
MB: It looks as though George W is going to support price fixing. He seems to have lost his principles.

ARTICLE TITLE: Surgeon found liable for injuries because did not inform patient of risks.
ARTICLE SOURCE: BMJ (England), Jun 15 2002, 324(7351) p1414
AUTHOR(S): Dyer C
PUBLICATION TYPE: Legal Cases; News
MB: A UK court has followed an Australian precedent. (Chapple v Hart 1998. Similar Wittaker v Rogers.)

ARTICLE TITLE: Expert shows how pens should be held.
ARTICLE SOURCE: BMJ (England), Jun 15 2002, 324(7351) p1457
AUTHOR(S): Middleton R
PUBLICATION TYPE: Letter
MB: Most residents & registrars should look at these diagrams.

ARTICLE TITLE: Withdrawal of life sustaining treatment.
ARTICLE SOURCE: BMJ (England), Jul 27 2002, 325(7357) p175-6
AUTHOR(S): Sensky T
PUBLICATION TYPE: Editorial
MB: About a case where a quadriplegic patient wanted to die. It was decided in court.

ARTICLE TITLE: Blood transfusion medicine.
ARTICLE SOURCE: BMJ (England), Jul 20 2002, 325(7356) p143-7
AUTHOR(S): Regan F; Taylor C
AUTHOR'S ADDRESS: Hammersmith Hospitals NHS Trust, London W12 0HS, b Royal Free Hampstead NHS Trust, London NW3 2QG. fiona.regan@nbs.nhs.uk.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
MB: About infection risks of transfusion.

ARTICLE TITLE: Surgeons cleared of manslaughter after removing wrong kidney.
ARTICLE SOURCE: BMJ (England), Jul 6 2002, 325(7354) p9
AUTHOR(S): Dyer C
PUBLICATION TYPE: Legal Cases; News
MB: Cause of death was an MI rather than taking out the one good kidney. I don't suppose taking out the wrong kidney helped much.

ARTICLE TITLE: Local warming and insertion of peripheral venous cannulas: single blinded prospective randomised controlled trial and single blinded randomised crossover trial
ARTICLE SOURCE: BMJ (England), Aug 24 2002, 325(7361) p409
AUTHOR(S): Lenhardt R; Seybold T; Kimberger O; Stoiser B; Sessler DI
PUBLICATION TYPE: Journal Article
Conclusions: Local warming facilitates the insertion of peripheral venous cannulas, reducing both time and number of attempts required. This may decrease the time staff spend inserting cannulas, reduce supply costs, and improve patient satisfaction.

ARTICLE TITLE: Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial
ARTICLE SOURCE: BMJ (England), Aug 17 2002, 325(7360) p362
AUTHOR(S): Girou E; Loyeau S; Legrand P; Oppein F; Brun-Buisson C
AUTHOR'S ADDRESS: Infection Control Unit, Hopital Henri Mondor, Assistance Publique-Hopitaux de Paris, Creteil, France. emmanuelle.girou@hmn.ap-hop-paris.fr.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: During routine patient care handrubbing with an alcohol based solution is significantly more efficient in reducing hand contamination than handwashing with antiseptic soap.

ARTICLE TITLE: Judge criticises paediatrician for "overstating" sex abuse allegations
ARTICLE SOURCE: BMJ (England), Aug 3 2002, 325(7358) p235A
AUTHOR(S): Dyer C
PUBLICATION TYPE: Journal Article
MB: The paediatrician had invented some of her evidence.

ARTICLE TITLE: A physician workforce planning model applied to Canadian anesthesiology: planning the future supply of anesthesiologists
ARTICLE SOURCE: Can J Anaesth (Canada), Aug 2002, 49(7) p671-7
AUTHOR(S): Craig D; Byrick R; Carli F
AUTHOR'S ADDRESS: Departments of Anesthesia, University of Manitoba, University of Toronto, and McGill University.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Canada has a current shortage of anesthesiologists. Based on the assessment of future needs in Quebec and extrapolated to all provinces, this shortage will worsen, unless Canadian training programs are expanded or other steps are taken to augment the numbers of anesthesia practitioners. Ongoing studies in each province are required to validate and update these conclusions.

ARTICLE TITLE: A physician workforce planning model applied to Canadian anesthesiology: assessment of needs:
ARTICLE SOURCE: Can J Anaesth (Canada), Aug 2002, 49(7) p663-70
AUTHOR(S): Byrick RJ; Craig D; Carli F
AUTHOR'S ADDRESS: Departments of Anaesthesia, University of Toronto, University of Manitoba, and McGill University.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Anesthesia human resource models: reality or pipe dreams?
ARTICLE SOURCE: Can J Anaesth (Canada), Aug 2002, 49(7) p650-4
AUTHOR(S): Donen N
AUTHOR'S ADDRESS: Department of Continuing Medical Education and Professional Development, Vancouver Island Health Authority, Royal Jubilee Hospital, Victoria, British Columbia, Canada.
PUBLICATION TYPE: Journal Article
MB: It's a pipe dream. It will not be put into action.

ARTICLE TITLE: A worldwide survey of the use of simulation in anesthesia:
ARTICLE SOURCE: Can J Anaesth (Canada), Aug 2002, 49(7) p659-62
AUTHOR(S): Morgan PJ; Cleave-Hogg D
AUTHOR'S ADDRESS: Department of Anesthesia, Sunnybrook & Women's College Health Sciences Centre, and The Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: From the survey responses received, opportunities for the simulator to be used for the assessment of performance appear to be under-utilized. This may be due to the lack of research in this area, lack of standardized, valid and reliable tests and the fact that most centres have only recently acquired this technology. Further research supporting the use of the simulator in education and evaluation is required.
MB: It may be that there is no satisfactory evidence to support the routine use. It is a worry that an article from a Centre for Research in Education is calling for research to support a particular method of teaching. I don't think I have seen any evidence of efficacy of simulators.

ARTICLE TITLE: Anesthesiology simulators: networking is the key.
ARTICLE SOURCE: Can J Anaesth (Canada), Aug 2002, 49(7) p647-9
AUTHOR(S): Girard M; Drolet P
AUTHOR'S ADDRESS: Department of Anesthesia, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada.
PUBLICATION TYPE: Journal Article
MB: Well. Maybe,

ARTICLE TITLE: Short-acting neuromuscular blocking drugs allow better control of OR time
ARTICLE SOURCE: Can J Anaesth (Canada), Jun 2002, 49(6) p635
AUTHOR(S): El-Orbany M
AUTHOR'S ADDRESS: Chicago, Illinois Graz, Austria.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: [2] Call for Re-evaluation of Mobile Phones in Hospitals
ARTICLE SOURCE: Can J Anaesth (Canada), Jun 2002, 49(6) p632-3
AUTHOR(S): Lam S
AUTHOR'S ADDRESS: Toronto, Ontario.
PUBLICATION TYPE: Journal Article
MB: They say that they are a problem in planes because they interfere with ground towers.

ARTICLE TITLE: Best evidence in anesthetic practice: Harm: albumin neither increases nor decreases mortality in critically ill patients
ARTICLE SOURCE: Can J Anaesth (Canada), Jun 2002, 49(6) p620-2
AUTHOR(S): Bryson GL; Choi PT
AUTHOR'S ADDRESS: Ottawa, Ontario Hamilton, Ontario.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Prophylactic ephedrine prevents hypotension during spinal anesthesia for Cesarean delivery but does not improve neonatal outcome: a quantitative systematic review:
ARTICLE SOURCE: Can J Anaesth (Canada), Jun 2002, 49(6) p588-99
AUTHOR(S): Lee A; Ngan Kee WD; Gin T
AUTHOR'S ADDRESS: Department of Anaesthesia, Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Nt, Hong Kong, China.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Serious intraoperative problems - a five-year review of 83,844 anesthetics:
ARTICLE SOURCE: Can J Anaesth (Canada), Jun 2002, 49(6) p545-53
AUTHOR(S): Fasting S; Gisvold SE
AUTHOR'S ADDRESS: Department of Anesthesia and Intensive Care, St. Olav's Hospital, University Hospital of Trondheim, Trondheim, Norway.
PUBLICATION TYPE: Journal Article
Intubation, emergence, arrhythmia, hypotension and anaphylaxis cause most serious problems, and should be the object of preventive strategies.
MB: I think they could have guessed that result.

ARTICLE TITLE: Sildenafil effects on exercise, neurohormonal activation, and erectile dysfunction in congestive heart failure: a double-blind, placebo-controlled, randomized study followed by a prospective treatment for erectile dysfunction
ARTICLE SOURCE: Circulation (United States), Aug 27 2002, 106(9) p1097-103
AUTHOR(S): Bocchi EA; Guimaraes G; Mocelin A; Bacal F; Bellotti G; Ramires JF
AUTHOR'S ADDRESS: Heart Failure Clinics, Heart Institute, Sao Paulo University Medical School, Sao Paulo, Brazil. dcledimar@incor.usp.br.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Sildenafil was tolerated and effective for erectile dysfunction (ED) treatment in congestive heart failure (CHF), and improved the exercise capacity. The reduction of heart rate (HR) during exercise with sildenafil could theoretically decrease the myocardial oxygen consumption during sexual activity.
MB: I wonder what it all means.

ARTICLE TITLE: Comparison of reported and expected deaths in sildenafil (Viagra) users.
ARTICLE SOURCE: Am J Cardiol (United States), Jun 1 2002, 89(11) p1331-4
AUTHOR(S): Wysowski DK; Farinas E; Swartz L
AUTHOR'S ADDRESS: Office of Drug Safety, Food and Drug Administration, Rockville, MD 20857, USA. wysowski@cder.fda.gov.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Cardiovascular safety of sildenafil (Viagra)
ARTICLE SOURCE: Int J STD AIDS (England), Jul 2002, 13(7) p439-43
AUTHOR(S): Kell P
AUTHOR'S ADDRESS: Archway Sexual Health Clinic, Highgate Hill, London N19 5NF, UK.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Tripling survival from sudden cardiac arrest via early defibrillation without traditional education in cardiopulmonary resuscitation
ARTICLE SOURCE: Circulation (United States), Aug 27 2002, 106(9) p1065-70
AUTHOR(S): Capucci A; Aschieri D; Piepoli MF; Bardy GH; Iconomu E; Arvedi M
AUTHOR'S ADDRESS: Division of Cardiology, Gugliemo da Saliceto Hospital, Piacenza, Italy. progettovita@hotmail.com.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Broad dissemination of semiautomatic external biphasic defibrillators (AEDs) for use by nonmedical volunteers enabled early defibrillation and tripled the survival rate for out-of-hospital sudden cardiac arrest (SCA).
MB: Well, that's an improvement.

ARTICLE TITLE: Impact of community-wide police car deployment of automated external defibrillators on survival from out-of-hospital cardiac arrest
ARTICLE SOURCE: Circulation (United States), Aug 27 2002, 106(9) p1058-64
AUTHOR(S): Myerburg RJ; Fenster J; Velez M; Rosenberg D; Lai S; Kurlansky P; Newton S; Knox M; Castellanos A
AUTHOR'S ADDRESS: Division of Cardiology, University of Miami School of Medicine, Miami, Fla 33101, USA. rmyerbur@med.miami.edu.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Automated external defibrillators (AEDs) -equipped police (P-AED) establishes a layer of responders that generate improved response times and survival from ventricular fibrillation or pulseless ventricular tachycardia (VT/VF). There was no benefit for victims with non-shockable rhythms.

ARTICLE TITLE: Automated external defibrillator use by police responders: where do we go from here?
ARTICLE SOURCE: Circulation (United States), Aug 27 2002, 106(9) p1030-3
AUTHOR(S): Joglar JA; Page RL
PUBLICATION TYPE: Editorial

ARTICLE TITLE: Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes
ARTICLE SOURCE: Circulation (United States), Aug 20 2002, 106(8) p974-80
AUTHOR(S): Al Suwaidi J; Reddan DN; Williams K; Pieper KS; Harrington RA; Califf RM; Granger CB; Ohman EM; Holmes DR
AUTHOR'S ADDRESS: Mayo Clinic and Foundation (J.A.S., D.R.H.), Rochester, Minn, and Duke University Medical Center, Durham, NC.
PUBLICATION TYPE: Status: In-Process
Journal Article
CONCLUSIONS: Patients presenting with acute coronary syndromes (ACS) frequently have abnormal renal function (RF). Abnormal RF is a marker of adverse baseline clinical characteristics and is independently associated with increased risk of death and death/ myocardial infarction (MI).
MB: Mine went up & then came down again. There was similar study some months ago.

ARTICLE TITLE: Consensus conference report: maximizing use of organs recovered from the cadaver donor: cardiac recommendations, March 28-29, 2001, Crystal City, Va
ARTICLE SOURCE: Circulation (United States), Aug 13 2002, 106(7) p836-41
AUTHOR(S): Zaroff JG; Rosengard BR; Armstrong WF; Babcock WD; D'Alessandro A; Dec GW; Edwards NM; Higgins RS; Jeevanandum V; Kauffman M; Kirklin JK; Large SR; Marelli D; Peterson TS; Ring WS; Robbins RC; Russell SD; Taylor DO; Van Bakel A; Wallwork J; Young JB
AUTHOR'S ADDRESS: UCSF Medical Center, San Francisco, Calif 94143-0124, USA. zaroff@medicine.ucsf.edu.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Renal transplantation. Spain's system for procuring organs operates in hospitals.
COMMENTS: Comment On: Comment On: RefSource:BMJ. 2002 Mar 2; 324(7336):530-4
ARTICLE SOURCE: BMJ (England), Jun 22 2002, 324(7352) p1524
AUTHOR(S): Lopez-Navidad A; Puigjaner RS
PUBLICATION TYPE: Comment; Letter
MB: Spain has more than twice the kidney donor rate than UK & Germany. (It's 4 times the Australian rate.)

ARTICLE TITLE: Endovascular stent grafting versus open surgical operation in patients with infrarenal aortic aneurysms: a propensity score-adjusted analysis
ARTICLE SOURCE: Circulation (United States), Aug 13 2002, 106(7) p782-7
AUTHOR(S): Teufelsbauer H; Prusa AM; Wolff K; Polterauer P; Nanobashvili J; Prager M; Holzenbein T; Thurnher S; Lammer J; Schemper M; Kretschmer G; Huk I
AUTHOR'S ADDRESS: Department of Vascular Surgery, University of Vienna-Medical School, Vienna, Austria. alexanderprusa@hotmail.com.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Transfemoral endovascular aneurysm management (TEAM) represents a less invasive procedure for abdominal aortic aneurysms (AAA) therapy in patients with significant preoperative risk factors. Especially in geriatric patients with multiple morbidities, TEAM offers a method of therapy with acceptable mortality rates (MRs) and 900-day survival estimates (Ses), making active treatment possible in otherwise incurable patients.
MB: I can't imagine anyone being inoperable. When we were about the only place in the world doing these we got some very bad risk pateints from all over Australia.

ARTICLE TITLE: Aspirin plus coumarin versus aspirin alone in the prevention of reocclusion after fibrinolysis for acute myocardial infarction: results of the Antithrombotics in the Prevention of Reocclusion In Coronary Thrombolysis (APRICOT)-2 Trial.
ARTICLE SOURCE: Circulation (United States), Aug 6 2002, 106(6) p659-65
AUTHOR(S): Brouwer MA; van den Bergh PJ; Aengevaeren WR; Veen G; Luijten HE; Hertzberger DP; van Boven AJ; Vromans RP; Uijen GJ; Verheugt FW
AUTHOR'S ADDRESS: Interuniversity Cardiology Institute of the Netherlands, Nijmegen.
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
CONCLUSIONS: As adjunctive to aspirin, a 3-month-regimen of moderate-intensity coumarin, including heparinization until the target INR is reached, markedly reduces reocclusion and recurrent events after successful fibrinolysis. This conceptual study provides a mechanistic rationale to further investigate the role of prolonged anticoagulation after fibrinolytic therapy.

ARTICLE TITLE: Successful cardiopulmonary resuscitation after cardiac arrest as a "sepsis-like" syndrome.
ARTICLE SOURCE: Circulation (United States), Jul 30 2002, 106(5) p562-8
AUTHOR(S): Adrie C; Adib-Conquy M; Laurent I; Monchi M; Vinsonneau C; Fitting C; Fraisse F; Dinh-Xuan AT; Carli P; Spaulding C; Dhainaut JF; Cavaillon JM
AUTHOR'S ADDRESS: Medical ICU, Cochin Hospital, Paris, France. christophe.adrie@wanadoo.fr.
PUBLICATION TYPE: Status: Completed
Clinical Trial; Controlled Clinical Trial; Journal Article
CONCLUSIONS: Altogether, the high levels of circulating cytokines, the presence of endotoxin in plasma, and the dysregulated production of cytokines found in these patients recall the immunological profile found in patients with sepsis.

ARTICLE TITLE: Beta-blockers in the post-myocardial infarction patient.
ARTICLE SOURCE: Circulation (United States), Jul 23 2002, 106(4) p394-8
AUTHOR(S): Gheorghiade M; Goldstein S
AUTHOR'S ADDRESS: Division of Cardiology, Northwestern Feinberg Medical School, Chicago, Ill 60611, USA. m-gheorghiade@northwestern.edu.
PUBLICATION TYPE: Journal Article
Conclusion The level of evidence supporting the use of [beta]-blockers in the chronic post-MI period is very strong. On the basis of much of the evidence presented here, the American Medical Association and 5 other collaborating medical organizations recently issued a "Quality of Care Alert," which taken as a whole, this evidence leads to the conclusion that [beta]-blockers should be administered to all post-MI patients without a contraindication and should be continued indefinitely, as recommended in the recent 2001 AHA/ACC Scientific Statement.
MB: Much of the stuff on perioperative beta blockers probably needs to be redone on patients already optimally managed with beta blockers etc. There is cardiology literature showing that lots of cardiac patients are not having optimal therapy.

ARTICLE TITLE: Effect of implantable defibrillators on arrhythmic events and mortality in the multicenter unsustained tachycardia trial.
ARTICLE SOURCE: Circulation (United States), Jul 9 2002, 106(2) p233-8
AUTHOR(S): Lee KL; Hafley G; Fisher JD; Gold MR; Prystowsky EN; Talajic M; Josephson ME; Packer DL; Buxton AE
AUTHOR'S ADDRESS: Department of Biostatistics and Bioinformatics, Duke University Medical Center, Duke Clinical Research Institute and Duke University School of Medicine, Durham, NC 27705, USA. Kerry.Lee@duke.edu; Collective Name: Multicenter Unsustained Tachycardia Trial Investigators. .
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
CONCLUSIONS: The benefit of electrophysiological (EP) -guided antiarrhythmic therapy observed in The Multicenter Unsustained Tachycardia Trial (MUSTT) was due to improved outcomes among patients who received an implantable defibrillators (ICDs) but not among patients who received antiarrhythmic drugs.

ARTICLE TITLE: Allopurinol and endothelial function in heart failure: future or fantasy?
COMMENTS: Comment On: Comment On: RefSource:Circulation. 2002 Jul 9; 106(2):221-6
ARTICLE SOURCE: Circulation (United States), Jul 9 2002, 106(2) p173-5
AUTHOR(S): Landmesser U; Drexler H
PUBLICATION TYPE: Comment; Editorial
Conclusions-: We have shown that allopurinol improves endothelial dysfunction in chronic heart failure. This raises the distinct possibility that allopurinol might reduce cardiovascular events and even improve exercise capacity in chronic heart failure.

ARTICLE TITLE: Interventions on prevention of postoperative atrial fibrillation in patients undergoing heart surgery: a meta-analysis.
ARTICLE SOURCE: Circulation (United States), Jul 2 2002, 106(1) p75-80
AUTHOR(S): Crystal E; Connolly SJ; Sleik K; Ginger TJ; Yusuf S
AUTHOR'S ADDRESS: Division of Cardiology, Faculty of Health Sciences, McMaster University, Ontario, Hamilton, Canada. crystal@bgumail.bgu.ac.il.
PUBLICATION TYPE: Journal Article; Meta-Analysis
CONCLUSIONS: Beta-blockers, sotalol, and amiodarone all reduce risk of postoperative atrial fibrillation (AF) with no marked difference between them. There is evidence that use of these drugs will reduce hospital length of stay (LOS). Biatrial pacing is a promising new treatment opportunity. There was no evidence that reducing postoperative AF reduces stroke; however, data on stroke are incomplete.

ARTICLE TITLE: And the answer is, it doesn't much matter.
COMMENTS: Comment On: Comment On: RefSource:Circulation. 2002 May 21; 105(20):2367-72
ARTICLE SOURCE: Circulation (United States), Jul 2 2002, 106(1) p11-3
AUTHOR(S): Holmes DR; Gersh BJ
PUBLICATION TYPE: Comment; Editorial
About therapy for angina. The current analysis by de Feyter et al focuses on the essential question, namely whether, with the then-current techniques (1997 to 1998), does the presence of unstable angina still matter in terms of the outcome of revascularization with either a catheter or a bypass operation. The answer is that it does not. The bottom line is that in the past, unstable angina was a bad actor; with current approaches, revascularization cares not whether the diagnosis is unstable or stable angina. In general, it does not matter nearly as much anymore.

ARTICLE TITLE: Defending the rationale for the two-tailed test in clinical research.
ARTICLE SOURCE: Circulation (United States), Jun 25 2002, 105(25) p3062-5
AUTHOR(S): Moye LA; Tita AT
AUTHOR'S ADDRESS: University of Texas Houston Health Science Center, School of Public Health, Houston, Tex, USA. lmoye@utsph.sph.uth.tmc.edu.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Disrobing the emperor (heart) without destroying the dignity of super-normality.
COMMENTS: Comment On: Comment On: RefSource:Circulation. 2002 Jun 25; 105(25):2992-7
ARTICLE SOURCE: Circulation (United States), Jun 25 2002, 105(25) p2934-6
AUTHOR(S): Roberts R
PUBLICATION TYPE: Comment; Editorial
MB: The familial hypertrophic heart is a hyperdynamic pump, not infrequently exhibited in the most elite of athletes. It is the most common cause of sudden cardiac death in the young.

ARTICLE TITLE: What is "the matter" with restenosis in 2002?
COMMENTS: Comment On: Comment On: RefSource:Circulation. 1999 Jan 5-12; 99(1):44-52; Comment On: Comment On: RefSource:Circulation. 2002 Jun 25; 105(25):2974-80
ARTICLE SOURCE: Circulation (United States), Jun 25 2002, 105(25) p2932-3
AUTHOR(S): Sousa JE; Costa MA; Sousa AG
PUBLICATION TYPE: Comment; Editorial
Although the new era of drug-eluting stents may drastically reduce the "matter" of restenosis, old lessons must not be forgotten. The field of interventional cardiology had a previous dilemma between acute gain and late loss.

ARTICLE TITLE: Meta-analysis of wine and beer consumption in relation to vascular risk.
COMMENTS: Comment In: Comment In: RefSource:Circulation. 2002 Jun 18; 105(24):2806-7
ARTICLE SOURCE: Circulation (United States), Jun 18 2002, 105(24) p2836-44
AUTHOR(S): Di Castelnuovo A; Rotondo S; Iacoviello L; Donati MB; De Gaetano G
AUTHOR'S ADDRESS: Department of Vascular Medicine and Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy.
PUBLICATION TYPE: Journal Article; Meta-Analysis
A statistically significant inverse association was found up to a daily intake of 150 mL of wine. The overall relative risk of moderate beer consumption, which was measured in 15 studies involving 208 036 persons, was 0.78 (95% confidence interval, 0.70 to 0.86). However, no significant relationship between different amounts of beer intake and vascular risk was found after meta-analyzing 7 studies involving 136 382 persons. CONCLUSIONS: These findings show evidence of a significant inverse association between light-to-moderate wine consumption and vascular risk. A similar, although smaller association was also apparent in beer consumption studies. The latter finding, however, is difficult to interpret because no meaningful relationship could be found between different amounts of beer intake and vascular risk.

ARTICLE TITLE: Wine, beer, and spirits: are they really horses of a different color?
COMMENTS: Comment On: Comment On: RefSource:Circulation. 2002 Jun 18; 105(24):2836-44
ARTICLE SOURCE: Circulation (United States), Jun 18 2002, 105(24) p2806-7
AUTHOR(S): Rimm EB; Stampfer MJ
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Improving outcomes in heart failure: It's not unusual beyond usual care.
COMMENTS: Comment On: Comment On: RefSource:Circulation. 2002 Jun 18; 105(24):2861-6
ARTICLE SOURCE: Circulation (United States), Jun 18 2002, 105(24) p2810-2
AUTHOR(S): Moser DK; Mann DL
PUBLICATION TYPE: Comment; Editorial
MB: Make sure they get the treatment & are systematically watched. (Based on an Adelaide study.)

ARTICLE TITLE: Management of the patient who has been resuscitated from sudden cardiac death.
ARTICLE SOURCE: Circulation (United States), Jun 11 2002, 105(23) p2704-7
AUTHOR(S): Callans DJ
AUTHOR'S ADDRESS: Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, USA. david.callans@uphs.upenn.edu.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Myocardial infarct: no one size fits all.
COMMENTS: Comment On: Comment On: RefSource:Circulation. 2002 Jun 4; 105(22):2605-10/PMID:12045165
ARTICLE SOURCE: Circulation (United States), Jun 4 2002, 105(22) p2577-9
AUTHOR(S): Pfeffer MA; McMurray JJ
PUBLICATION TYPE: Comment; Editorial
MB: A general useful review.

ARTICLE TITLE: Sudden death predictors: an inflammatory association.
COMMENTS: Comment On: Comment On: RefSource:Circulation. 2002 Jun 4; 105(22):2595-9
ARTICLE SOURCE: Circulation (United States), Jun 4 2002, 105(22) p2574-6
AUTHOR(S): Spooner PM; Zipes DP
PUBLICATION TYPE: Comment; Editorial
Conclusions-: These prospective data suggest that C-reactive protein (CRP), levels may be useful in identifying apparently healthy men who are at an increased long-term risk of sudden cardiac death (SCD).

ARTICLE TITLE: More reliable oximetry reduces the frequency of arterial blood gas analyses and hastens oxygen weaning after cardiac surgery: a prospective, randomized trial of the clinical impact of a new technology
ARTICLE SOURCE: Crit Care Med (United States), Aug 2002, 30(8) p1735-40
AUTHOR(S): Durbin CG; Rostow SK
AUTHOR'S ADDRESS: Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Provision of more reliable oximetry allows caregivers to act in a more efficient and cost-effective manner in regard to oxygen weaning and use of arterial blood gas measurements. Investigating the effect of a monitor on the process of care, rather than simply its accuracy and precision, is a useful, relevant paradigm for evaluating the value and impact of a new technology.

ARTICLE TITLE: Severe anemia after gastrointestinal hemorrhage in a Jehovah's Witness: New treatment strategies.
ARTICLE SOURCE: Crit Care Med (United States), Aug 2002, 30(8) p1893-5
AUTHOR(S): Gannon CJ; Napolitano LM
AUTHOR'S ADDRESS: Department of Surgery, University of Maryland School of Medicine and VA Maryland Health Care System, Baltimore, MD.
PUBLICATION TYPE: Journal Article
A total of 7 units of a bovine hemoglobin-based oxygen carrying compound (HBOC-201) was administered to enhance the patient's oxygen delivery. High-dose recombinant human erythropoietin was administered daily (500 units/kg)

ARTICLE TITLE: Management of severe head injury: Institutional variations in care and effect on outcome
ARTICLE SOURCE: Crit Care Med (United States), Aug 2002, 30(8) p1870-6
AUTHOR(S): Bulger EM; Nathens AB; Rivara FP; Moore M; MacKenzie EJ; Jurkovich GJ
AUTHOR'S ADDRESS: Department of Surgery (EMB, ABN, GJJ) and the Department of Pediatrics (FPR), University of Washington, Seattle, WA; University HealthSystem Consortium (MM); and Johns Hopkins School of Public Health (EM), Baltimore, MD.
PUBLICATION TYPE: Journal Article
SETTING: Thirty-four academic trauma centers in the United States PATIENTS: All patients admitted with a presenting Glasgow Coma Scale score </=8. MEASUREMENTS AND MAIN RESULTS: Variations in care were assessed, including prehospital intubation, intracranial pressure monitoring, use of osmotic agents, hyperventilation, and computed tomography scan utilization. Aggressive centers were defined as those placing intracranial pressure monitors in >50% of patients meeting the Brain Trauma Foundation criteria for intracranial pressure monitoring. CONCLUSION: Considerable national variation in the care of severely head-injured patients persists. An "aggressive" management strategy is associated with decreased mortality rate for patients with severe head injury, with no significant difference in functional status at discharge among survivors.

ARTICLE TITLE: Meta-analysis of hemodynamic optimization in high-risk patients.
ARTICLE SOURCE: Crit Care Med (United States), Aug 2002, 30(8) p1686-92
AUTHOR(S): Kern JW; Shoemaker WC
AUTHOR'S ADDRESS: USC School of Pharmacy (JWK), the LAC +USC Medical Center, Division of Trauma/Critical Care Medicine (JWK, WCS), and the Laboratory of Applied Pharmacokinetics (JWK, WCS), Keck School of Medicine, University of Southern California, Los Angeles, CA.
PUBLICATION TYPE: Journal Article
CONCLUSION: Review of 21 randomized controlled trials with various approaches to treatment revealed statistically significant mortality reductions, with hemodynamic optimization, when patients with acute critical illness were treated early to achieve optimal goals before the development of organ failure, when there were control group mortalities of >20% and when therapy produced differences in oxygen delivery between the control and protocol groups.

ARTICLE TITLE: How reliable is the Bispectral Index in critically ill patients? A prospective, comparative, single-blinded observer study
ARTICLE SOURCE: Crit Care Med (United States), Jul 2002, 30(7) p1483-7
AUTHOR(S): Nasraway SASA; Wu EC; Kelleher RM; Yasuda CM; Donnelly AM
AUTHOR'S ADDRESS: Department of Surgery, New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA. Snasraway@lifespan.org.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The correlation between Sedation-Agitation Scale (SAS) and Bispectral Index (BIS), scores was suboptimal and inconsistent in a heterogeneous group of critically ill patients. The generation of BIS hardware and software, studied herein, is neither reliable nor valid for routinely monitoring the level of consciousness in the critically ill patient. Excessive muscle movement by the patient is an important and spurious influence on BIS values and seriously undermines BIS reliability.

ARTICLE TITLE: There and back again: Does prone positioning have any value in respiratory failure?
ARTICLE SOURCE: Crit Care Med (United States), Jul 2002, 30(7) p1658-9
AUTHOR(S): Dalton HJ
AUTHOR'S ADDRESS: Critical Care Medicine; Children's National Medical Center; George Washington University; Washington, DC.
PUBLICATION TYPE: Editorial

ARTICLE TITLE: Is there a benefit to postpyloric feeding?
ARTICLE SOURCE: Crit Care Med (United States), Jul 2002, 30(7) p1654-6
AUTHOR(S): Maykel JA; Pazirandeh S; Bistrian BR
AUTHOR'S ADDRESS: Beth Israel Deaconess Medical Center; Harvard Medical School; Boston, MA.
PUBLICATION TYPE: Editorial

ARTICLE TITLE: The hemodynamically unstable patient in the intensive care unit: hemodynamic vs. transesophageal echocardiographic monitoring.
ARTICLE SOURCE: Crit Care Med (United States), Jun 2002, 30(6) p1214-23
AUTHOR(S): Costachescu T; Denault A; Guimond JG; Couture P; Carignan S; Sheridan P; Hellou G; Blair L; Normandin L; Babin D; Allard M; Harel F; Buithieu J
AUTHOR'S ADDRESS: Department of Anesthesiology, CHUM, Notre-Dame Hospital, Quebec, Canada.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: These observations support the belief that transesophageal echocardiographic monitoring in the intensive care unit is associated with higher interobserver agreement in diagnosing and excluding significant causes of hemodynamic instability for postoperative cardiac surgical patients.
MB: The title is misleading. There was no competion. The addition of the transoesplhageal echo to other haemodynamic data reduced the inter-observer differences.

ARTICLE TITLE: Selective decontamination of the digestive tract to prevent postoperative infection: a randomized placebo-controlled trial in liver transplant patients.
ARTICLE SOURCE: Crit Care Med (United States), Jun 2002, 30(6) p1204-9
AUTHOR(S): Zwaveling JH; Maring JK; Klompmaker IJ; Haagsma EB; Bottema JT; Laseur M; Winter HL; van Enckevort PJ; Ten Vergert EM; Metselaar HJ; Bruining HA; Slooff MJ
AUTHOR'S ADDRESS: Department of Surgery, Livertransplant Group Groningen, University Hospital Groningen, Groningen, The Netherlands.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: Selective decontamination of the digestive tract does not prevent infection in patients undergoing elective liver transplantation and increases the cost of their care. It does, however, affect the type of infection. Infections with Gram-negative bacilli and with Candida species are replaced by infections with Gram-positive cocci.

ARTICLE TITLE: Pulmonary artery occlusion pressure estimation: how confident are anesthesiologists?
COMMENTS: Comment In: Comment In: RefSource:Crit Care Med. 2002 Jun; 30(6):1383-4
ARTICLE SOURCE: Crit Care Med (United States), Jun 2002, 30(6) p1197-203
AUTHOR(S): Jacka MJ; Cohen MM; To T; Devitt JH; Byrick R
AUTHOR'S ADDRESS: Department of Anaesthesia and Critical Care, University of Alberta.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Estimation of a sample pulmonary artery occlusion pressure trace by practicing anesthesiologists was in only modest agreement with expert assessment and published standards. Anesthesiologists demonstrated substantially less confidence in pulmonary artery occlusion pressure estimation than in the optimal timing of pulmonary artery occlusion pressure estimation. Before the effectiveness of the pulmonary artery catheter in clinical care can be systematically assessed, efforts are needed to enhance accuracy and consistency of pulmonary artery occlusion pressure estimation.
MB: Copies of records were sent out.

ARTICLE TITLE: Evidence-based medicine as it applies to acid suppression in the hospitalized patient.
ARTICLE SOURCE: Crit Care Med (United States), Jun 2002, 30(6 Suppl) pS373-8
AUTHOR(S): Cash BD
AUTHOR'S ADDRESS: Gastroenterology Division, Naval Hospital Camp Lejeune, Camp Lejeune, NC, USA.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
An evidence-based-medicine review of published trials yields sufficient evidence to support the use of prophylactic acid suppression in critically ill patients with coagulopathy or in those who are receiving prolonged mechanical ventilation. Not enough data have accumulated to prove the superiority of intravenous proton pump inhibitors to intravenous histamine-2-receptor antagonists for prophylaxis of clinically important stress ulcer bleeding. With respect to acute gastrointestinal bleeding, however, two well-conducted trials indicate that an intravenous proton pump inhibitor is significantly more effective than an intravenous histamine-2-receptor antagonist or placebo in reducing the rate of rebleeding after hemostasis in patients with bleeding peptic ulcer.

ARTICLE TITLE: Acidification of formula with citric acid is equally effective and better tolerated than acidification with hydrochloric acid
ARTICLE SOURCE: Crit Care Med (United States), Aug 2002, 30(8) p1701-4
AUTHOR(S): Mehall JR; Saltzman DA; Jackson RJ; Smith SD
AUTHOR'S ADDRESS: Department of Pediatric Surgery, Arkansas Children's Hospital, The University of Arkansas for Medical Sciences, Little Rock, AR.
PUBLICATION TYPE: Journal Article
CONCLUSION: Acidification of formula with citric acid is equally protective against bacteria but better tolerated than acidification with hydrochloric acid.
MB: Well which way do you want to push acidification?

ARTICLE TITLE: Acute upper gastrointestinal bleeding in critically ill patients: causes and treatment modalities.
ARTICLE SOURCE: Crit Care Med (United States), Jun 2002, 30(6 Suppl) pS365-8
AUTHOR(S): Conrad SA
AUTHOR'S ADDRESS: Department of Medicine and Emergency Medicine, LSU Health Sciences Center, Shreveport, LA 71130-3932, USA. sconrad@lushsc.edu.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
Omeprazole, an intravenous proton pump inhibitor, significantly reduced the rate of rebleeding in a recent placebo-controlled trial in which only patients with endoscopic confirmation of successful hemostasis were enrolled. Although this drug does not seem to reduce the need for surgical intervention or to decrease mortality, the trial does indicate the promise of intravenous proton pump inhibitors in reducing upper gastrointestinal bleeding. Evidence from additional well-controlled trials is needed to confirm this finding. The use of proton pump inhibitors in this setting also may have a positive economic impact, and a decrease in the percentage of patients who experience rebleeding will eliminate the cost of further management strategies in those cases.

ARTICLE TITLE: Effects of a multifaceted, multidisciplinary, hospital-wide quality improvement program on weaning from mechanical ventilation.
ARTICLE SOURCE: Crit Care Med (United States), Jun 2002, 30(6) p1224-30
AUTHOR(S): Smyrnios NA; Connolly A; Wilson MM; Curley FJ; French CT; Heard SO; Irwin RS
AUTHOR'S ADDRESS: Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: A multifaceted, multidisciplinary weaning management program can change the process of care used for weaning patients from mechanical ventilation throughout an acute care hospital and across multiple services. This change can lead to large reductions in the duration of mechanical ventilation, length of stay, and hospital costs, even at a time when patients are sicker.

ARTICLE TITLE: Ketamine vs. propofol: how safe is safe enough?
COMMENTS: Comment On: Comment On: RefSource:Crit Care Med. 2002 Jun; 30(6):1231-6
ARTICLE SOURCE: Crit Care Med (United States), Jun 2002, 30(6) p1384-6
AUTHOR(S): Kapklein MJ; Slonim AD
PUBLICATION TYPE: Comment; Editorial
Ketamine and propofol are both effective agents for procedural sedation in children. As their track records lengthen, adverse event reports will accumulate and better inform clinical decisions regarding their respective safety profiles.
MB: I don't think that's the way to find that answer.

ARTICLE TITLE: Gastroenterologist-administered propofol versus meperidine and midazolam for advanced upper endoscopy: a prospective, randomized trial.
COMMENTS: Comment In: Comment In: RefSource:Gastroenterology. 2002 Jul; 123(1):373-5
ARTICLE SOURCE: Gastroenterology (United States), Jul 2002, 123(1) p8-16
AUTHOR(S): Vargo JJ; Zuccaro G; Dumot JA; Shermock KM; Morrow JB; Conwell DL; Trolli PA; Maurer WG
AUTHOR'S ADDRESS: Department of Gastroenterology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
METHODS: Seventy-five randomized patients received either gastroenterologist-administered propofol (n = 38) or meperidine/midazolam (n = 37) for endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. CONCLUSIONS: Gastroenterologist-administered propofol using monitoring with capnography is similar to meperidine/midazolam for both physiological outcomes and patient/endoscopist satisfaction. Propofol leads to significantly improved recovery of baseline activity and food intake 24 hours after the procedure. Our model suggests that propofol would be more cost-effective than meperidine and midazolam for endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography if registered nurse administration were possible.

ARTICLE TITLE: Propofol for conscious sedation?
COMMENTS: Comment On: Comment On: RefSource:Gastroenterology. 2002 Jul; 123(1):8-16
ARTICLE SOURCE: Gastroenterology (United States), Jul 2002, 123(1) p373-5
AUTHOR(S): Byrne MF; Baillie J
PUBLICATION TYPE: Comment; Editorial; Review; Review, Tutorial
MB: This editorial writer and the above authors have no idea that in 75 endoscopies they would not expect one death. A survey in the UK some years ago found a mortality of somewhat less than 1 in 2000. They refer to conscious sedation but commonly their patients are unconscious.

ARTICLE TITLE: Prediction of mortality from coronary heart disease among diverse populations: is there a common predictive function?
ARTICLE SOURCE: Heart (England), Sep 2002, 88(3) p222-8
AUTHOR'S ADDRESS: Collective Name: Diverse Populations Collaborative Group.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: When considered qualitatively, the major risk factors are associated with CHD mortality in a diverse set of populations. However, when considered quantitatively, there was significant heterogeneity in all three aspects: ordering risk, magnitude of relative risks, and estimation of absolute risk.

ARTICLE TITLE: Endovascular stent repair for a dissecting thoracoabdominal aneurysm is feasible in the setting of a district general hospital: a multidisciplinary approach
ARTICLE SOURCE: Heart (England), Aug 2002, 88(2) pE4-4
AUTHOR(S): Zaman MJ; Carre V; Parvin S; Shepherd D; Radvan J
AUTHOR'S ADDRESS: Royal Bournemouth Hospital, Castle Lane East, Bournemouth, UK.
PUBLICATION TYPE: Journal Article
ABSTRACT: A patient presented to a district general hospital with a type B dissection of the aorta. He was deemed too unwell for surgical intervention. An endovascular stent repair was successfully carried out. The case shows that such a procedure can be safely performed by a multidisciplinary team within a district general hospital.
MB: One swallow does not a summer make.

ARTICLE TITLE: Physician administered sedation for DC cardioversion
ARTICLE SOURCE: Heart (England), Aug 2002, 88(2) p117-8
AUTHOR(S): Harrison SJ; Mayet J
AUTHOR'S ADDRESS: Department of Anaesthetics, Lister Hospital, Stevenage, Hertfordshire, UK Peart-Rose-Waller Centre for Circulatory Health, St Mary's Hospital, Imperial College, London, UK.
PUBLICATION TYPE: Journal Article
ABSTRACT: Providing anaesthetic cover for DC cardioversion can sometimes prove a challenge for the cardiologist, with potentially disastrous consequences for the patient.
MB: Pointing out the problems if anaesthetists don't do these & the lack of power in studies claiming to show feasibility.

ARTICLE TITLE: Are we getting the point? Needlestick injuries-an ongoing problem
ARTICLE SOURCE: Int J STD AIDS (England), Jul 2002, 13(7) p453-5
AUTHOR(S): McAdam TK; McLaughlin RE; McNicholl B
AUTHOR'S ADDRESS: Emergency Department, Royal Victoria Hospital, Grosvenor Rd, Belfast BT12 6BA, UK.
PUBLICATION TYPE: Journal Article
ABSTRACT: The pattern of glove perforation using hollow needles is unknown and the incidence, using sensitive electronic methods has not been described. We wished to identify the glove perforation rate following the use of hollow needles in our Emergency Department. Two hundred and eighty-nine gloves were collected over three months. These gloves were electronically tested and compared with one hundred unused control gloves. There were 28/298 perforations (9.7%) vs 1/100 in the control group (P<0.01 Fisher's exact probability). Most perforations were located on the thumb and index fingers. There were no needlestick injuries reported during this period. The glove perforation rate following hollow needle use in our Emergency Department is higher than previously reported. The pattern of perforation suggests injury by the needle held in the dominant hand.

ARTICLE TITLE: Appropriate pain management in orthopaedic trauma care
ARTICLE SOURCE: J Bone Joint Surg Am (United States), Aug 2002, 84-A(8) p1479-80
AUTHOR(S): Rimmer J; Shaylor PJ; Whitesides TE
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Prevalence of Fat Embolism Following Bilateral Simultaneous and Unilateral Total Hip Arthroplasty Performed with or without Cement : A Prospective, Randomized Clinical Study
ARTICLE SOURCE: J Bone Joint Surg Am (United States), Aug 2002, 84-A(8) p1372-9
AUTHOR(S): Kim YH; Oh SW; Kim JS
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The prevalence of fat and bone-marrow-cell embolization was similar in the groups managed with bilateral simultaneous and unilateral total hip arthroplasty as well as in the groups managed with cemented and cementless stems.

ARTICLE TITLE: Are we losing objectivity?
ARTICLE SOURCE: J Bone Joint Surg Am (United States), Jul 2002, 84-A(7) p1254-8
AUTHOR(S): Sarmiento A
PUBLICATION TYPE: Journal Article
MB: About ueless treatment in hopeless situations.

ARTICLE TITLE: Does the reimbursement of anesthesiologists for intraoperative transesophageal echocardiography promote increased utilization?
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Jun 2002, 16(3) p300-3
AUTHOR(S): Morewood GH; Gallagher ME; Gaughan JP
AUTHOR'S ADDRESS: Departments of Anesthesiology and Biostatistics, Temple University School of Medicine, Philadelphia, PA.
PUBLICATION TYPE: Journal Article
CONCLUSION: The use of intraoperative intraoperative transesophageal echocardiography (TEE) by anesthesiologists does not seem to be related to the availability of reimbursement from Medicare.
MB: Seems?

ARTICLE TITLE: Neuroprotection is associated with beta-adrenergic receptor antagonists during cardiac surgery: Evidence from 2,575 patients
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Jun 2002, 16(3) p270-7
AUTHOR(S): Amory DW; Grigore A; Amory JK; Gerhardt MA; White WD; Smith PK; Schwinn DA; Reves JG; Newman MF
AUTHOR'S ADDRESS: Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Duke University Heart Center, Durham, NC.
PUBLICATION TYPE: Journal Article
CONCLUSION: Use of beta-adrenergic antagonists was associated with a substantial reduction in the incidence of postoperative neurologic complications. A prospective randomized trial is needed to verify this potentially important neuroprotective strategy in cardiac surgery.
MB: Maybe they all should have been on beta blockers before surgery.

ARTICLE TITLE: Con: Regional anesthesia is not an important component of the anesthetic technique for pediatric patients undergoing cardiac surgical procedures
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Jun 2002, 16(3) p379-81
AUTHOR(S): Holtby H
AUTHOR'S ADDRESS: Department of Cardiac Anesthesia, Hospital for Sick Children, and University of Toronto, Toronto, Ontario, Canada.
PUBLICATION TYPE:Journal Article

ARTICLE TITLE: Pro: Regional anesthesia is an important component of the anesthetic technique for pediatric patients undergoing cardiac surgical procedures
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Jun 2002, 16(3) p374-8
AUTHOR(S): Rosen DA; Rosen KR; Hammer GB
AUTHOR'S ADDRESS: Department of Anesthesiology, West Virginia University, Morgantown, WV.
PUBLICATION TYPE: Journal Article
MB: Its not an important component at any age.

ARTICLE TITLE: Management of a liver transplant in a patient with asymptomatic superior vena cava obstruction
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Jun 2002, 16(3) p347-50
AUTHOR(S): Feierman DE; Barlow JC; Fishbein TM
AUTHOR'S ADDRESS: Departments of Anesthesiology and Surgery, The Mount Sinai Medical Center, New York, NY.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Reversal of paraplegia via cerebrospinal fluid drainage after abdominal aortic surgery
ARTICLE SOURCE: J Cardiothorac Vasc Anesth (United States), Aug 2002, 16(4) p471-2
AUTHOR(S): Garutti I; Fernandez C; Bardina A; Martinez E; Ferrando A; Fernandez-Quero L
AUTHOR'S ADDRESS: Department de Anestesiologia, Reanimacion y Terapia del dolor, Hospital General Universitario Gregorio Maranon, Madrid, Spain.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: An outbreak of neonatal deaths in Brazil associated with contaminated intravenous fluids.
ARTICLE SOURCE: J Infect Dis (United States), Jul 1 2002, 186(1) p81-6
AUTHOR(S): Garrett DO; McDonald LC; Wanderley A; Wanderley C; Miller P; Carr J; Arduino M; Sehulster L; Anderson R; Jarvis WR
AUTHOR'S ADDRESS: Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Intraoperative lidocaine injection into the carotid sinus during endarterectomy.
ARTICLE SOURCE: J Neurosurg (United States), Jul 2002, 97(1) p80-3
AUTHOR(S): Maher CO; Wetjen NM; Friedman JA; Meyer FB
AUTHOR'S ADDRESS: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
PUBLICATION TYPE: Clinical Trial; Journal Article
CONCLUSIONS: Injection of lidocaine into the carotid sinus at the time of endarterectomy is not associated with a significant improvement in any hemodynamic factor, from the time of restoration of CA blood flow to postoperative Day
MB: I've always thought the local into the carotid sheath was for problems during the operation.

ARTICLE TITLE: First appearance and sense of the term "spinal column" in ancient Egypt. Historical vignette.
ARTICLE SOURCE: J Neurosurg (United States), Jul 2002, 97(1 Suppl) p152-5
AUTHOR(S): Lang JK; Kolenda H
AUTHOR'S ADDRESS: Department of Neurosurgery, Georg-August-University of Gottingen, Germany. jk_lang@t-online.de.
PUBLICATION TYPE: Historical Article; Journal Article

ARTICLE TITLE: Vasospasm.
COMMENTS: Comment On: Comment On: RefSource:J Neurosurg. 2002 Jun; 96(6):1094-102
ARTICLE SOURCE: J Neurosurg (United States), Jun 2002, 96(6) p985-6; discussion 986-7
AUTHOR(S): Dumont AS; Chow M; Kassell NF
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Myocardial infarction with angiographically normal coronary arteries
ARTICLE SOURCE: J R Soc Med (England), Aug 2002, 95(8) p398-400
AUTHOR(S): Chandrasekaran B; Kurbaan AS
AUTHOR'S ADDRESS: Departments of Cardiology, London Chest and Homerton Hospitals, London, UK.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Neuromuscular blocking drugs: discovery and development.
ARTICLE SOURCE: J R Soc Med (England), Jul 2002, 95(7) p363-7
AUTHOR(S): Raghavendra T
AUTHOR'S ADDRESS: Department of Anaesthetics, Royal Manchester Children's Hospital, Manchester M27 4HA, UK. raghavendra@btinternet.com.
PUBLICATION TYPE: Historical Article; Journal Article

ARTICLE TITLE: The autopsy: lessons from the National Confidential Enquiry into Perioperative Deaths.
ARTICLE SOURCE: J R Soc Med (England), Jul 2002, 95(7) p328-30
AUTHOR(S): Carr NJ; Burke MM; Corbishley CM; Suarez V; McCarthy KP
AUTHOR'S ADDRESS: Pathology Advisor to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), 35-43 Lincoln's Inn Fields, London WC2A 3PE, UK. Norman.Carr@suht.swest.nhs.uk.
PUBLICATION TYPE: Journal Article
MB: Only 30% have them in the UK but 21% of those show unexpected results. Autopsies have virtually stopped around here.

ARTICLE TITLE: Autopsies in trauma do not add to peer review or quality assurance
ARTICLE SOURCE: J Trauma (United States), Aug 2002, 53(2) p321-5
AUTHOR(S): Forsythe RM; Livingston DH; Lavery RF; Mosenthal AC; Hauser CJ
AUTHOR'S ADDRESS: Department of Surgery, New Jersey Medical School, Newark, New Jersey.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Acute renal failure after punishment beatings.
ARTICLE SOURCE: J R Soc Med (England), Jun 2002, 95(6) p300-1
AUTHOR(S): Bowley DM; Buchan C; Khulu L; Boffard KD
AUTHOR'S ADDRESS: Trauma Unit, Johannesburg Hospital and Department of Surgery, University of the Witwatersrand Medical School, Johannesburg, South Africa.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Accuracy of short-duration creatinine clearance determinations in predicting 24-hour creatinine clearance in critically ill and injured patients
ARTICLE SOURCE: J Trauma (United States), Aug 2002, 53(2) p267-71
AUTHOR(S): Cherry RA; Eachempati SR; Hydo L; Barie PS
AUTHOR'S ADDRESS: Department of Surgery, Lincoln Medical and Mental Health Center, Bronx, New York, USA.
PUBLICATION TYPE: Journal Article
CONCLUSION: CrCl2, CrCl6, and CrCl24calc are unreliable for clinical decision making. A minimum collection period of at least 8 hours is recommended for determination of urine creatinine clearance.

ARTICLE TITLE: Risk of death among cases attending South Australian major trauma services after severe trauma: the first 4 years of operation of a state trauma system
ARTICLE SOURCE: J Trauma (United States), Aug 2002, 53(2) p333-9
AUTHOR(S): Brennan PW; Everest ER; Griggs WM; Slater A; Carter L; Lee C; Semmens JK; Wood DJ; Nguyen AM; Owen DL; Pilkington P; Roder DM; Somers RL
AUTHOR'S ADDRESS: Master of Applied Epidemiology (Disease Control) Program, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia.
PUBLICATION TYPE: Journal Article
CONCLUSION: Results show a decrease in risk of death of patients attending South Australian major trauma services, from injuries of equivalent severity, during the first 4 years of operation of the State Trauma System.

ARTICLE TITLE: Kangaroo-related motor vehicle collisions
ARTICLE SOURCE: J Trauma (United States), Aug 2002, 53(2) p360-3
AUTHOR(S): Abu-Zidan FM; Parmar KA; Rao S
AUTHOR'S ADDRESS: Trauma Services (F.M.A.-Z., S.R.) and Department of Emergency Medicine (K.A.P.), Royal Perth Hospital, Perth, Western Australia, Australia.
PUBLICATION TYPE: Journal Article
CONCLUSION: Most kangaroo-related motor vehicle collisions occurred at night, in the countryside, and on highways when the driver tried to avoid a kangaroo. Although injuries resulting from these collisions are relatively mild, increased awareness of their presence and ways to reduce them have to be promoted.

ARTICLE TITLE: Analysis of prehospital transport of head-injured patients after consolidation of neurosurgery
ARTICLE SOURCE: J Trauma (United States), Aug 2002, 53(2) p345-50
AUTHOR(S): Holmen CD; Sosnowski T; Latoszek KL; Dow D; Rowe BH
AUTHOR'S ADDRESS: Division of Emergency Medicine (C.D.H., T.S., B.H.R.) and Department of Public Health Sciences (B.H.R.), University of Alberta, Edmonton Emergency Medical Services (D.D., T.S.), and Regional Trauma Program, Capital Health (K.L.), Edmonton, Alberta, Canada.
PUBLICATION TYPE: Journal Article
CONCLUSION: Unpredictable patient factors were the most frequent reasons patients required secondary transfer; few protocol violations or system factors were identified. No modifications to the current NS triage criteria are recommended.

ARTICLE TITLE: Missed and mismanaged injuries of the spinal cord
ARTICLE SOURCE: J Trauma (United States), Aug 2002, 53(2) p314-20
AUTHOR(S): Poonnoose PM; Ravichandran G; McClelland MR
AUTHOR'S ADDRESS: Princess Royal Spinal Injury Unit, Sheffield, United Kingdom.
PUBLICATION TYPE: Journal Article
CONCLUSION: Despite a greater awareness of the potential for spinal injury after road traffic accidents, failure to recognize a spinal cord injury in the acute care setting appears to be increasing. Injuries are seldom missed because of an isolated cause, but rather because of a combination of several factors. Increased vigilance on the part of the primary care physicians and careful documentation may reduce allegations of medical negligence.

ARTICLE TITLE: Seat belts are more effective than airbags in reducing thoracic aortic injury in frontal motor vehicle crashes
ARTICLE SOURCE: J Trauma (United States), Aug 2002, 53(2) p309-13
AUTHOR(S): Brasel KJ; Quickel R; Yoganandan N; Weigelt JA
AUTHOR'S ADDRESS: Departments of Surgery (K.J.B., J.A.W.) and Neurosurgery (N.Y.), Medical College of Wisconsin, Milwaukee, Wisconsin, and the Department of Surgery, Hennepin County Medical Center (R.Q.), Minneapolis, Minnesota.
PUBLICATION TYPE: Journal Article
CONCLUSION: Seat belts are considerably more effective in preventing TAI than airbags after frontal motor vehicle crashes. Prevention efforts should continue to emphasize the use of active restraints. Restraint use should be considered a risk factor in evaluating patients for potential TAI.
MB: I have both.

ARTICLE TITLE: Massive transfusion exceeding 50 units of blood products in trauma patients
ARTICLE SOURCE: J Trauma (United States), Aug 2002, 53(2) p291-6
AUTHOR(S): Vaslef SN; Knudsen NW; Neligan PJ; Sebastian MW
AUTHOR'S ADDRESS: Departments of Surgery (S.N.V., M.W.S.) and Anesthesiology (N.W.K., P.J.N.), Duke University Medical Center, Durham, North Carolina.
PUBLICATION TYPE: Journal Article
CONCLUSION: The 43% survival rate in trauma patients receiving > 50 units of blood products warrants continued aggressive transfusion therapy in the first 24 hours after admission.
MB: Don't give up.

ARTICLE TITLE: Acute traumatic rupture of the thoracic aorta treated with endoluminal stent grafts.
ARTICLE SOURCE: J Trauma (United States), Jun 2002, 52(6) p1173-7
AUTHOR(S): Thompson CS; Rodriguez JA; Ramaiah VG; Di Mugno L; Shafique S; Olsen D; Diethrich EB
AUTHOR'S ADDRESS: Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute and Arizona Heart Hospital, Phoenix, Arizona 85012, USA.
PUBLICATION TYPE: Journal Article
CONCLUSION: Five cases of successful endograft repair of thoracic aortic rupture have been demonstrated. This should encourage future studies to determine whether endovascular repair of thoracic aortic ruptures is a safe and feasible alternative to conventional open repair.

ARTICLE TITLE: Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality.
ARTICLE SOURCE: J Trauma (United States), Jun 2002, 52(6) p1141-6
AUTHOR(S): Dutton RP; Mackenzie CF; Scalea TM
AUTHOR'S ADDRESS: R Adams Cowley Shock Trauma Center and the Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. rdutton@umaryland.edu.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSION: Titration of initial fluid therapy to a lower than normal systolic blood pressure (SBP during active hemorrhage did not affect mortality in this study. Reasons for the decreased overall mortality and the lack of differentiation between groups likely include improvements in diagnostic and therapeutic technology, the heterogeneous nature of human traumatic injuries, and the imprecision of SBP as a marker for tissue oxygen delivery.

ARTICLE TITLE: Could a regional trauma system in eastern Switzerland decrease the mortality of blunt polytrauma patients? A prospective cohort study.
ARTICLE SOURCE: J Trauma (United States), Jun 2002, 52(6) p1030-6
AUTHOR(S): Osterwalder JJ
AUTHOR'S ADDRESS: Emergency Department, Cantonal Hospital, St. Gallen, Switzerland. joseph.osterwalder@kssg.ch.
PUBLICATION TYPE: Journal Article
CONCLUSION: It is likely that a regional trauma system in eastern Switzerland for polytrauma patients with an ISS of 8 or more would have a moderately positive effect on mortality. During the period of observation, transferred admissions from regional hospitals to our trauma center had a 46% higher mortality than predicted. In absolute terms, therefore, with a regional trauma system, it might have been possible to avoid between one death every 2 to 3 years and two to three deaths every year.

ARTICLE TITLE: Renal failure in the ICU: Comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes ARTICLE SOURCE: Kidney Int (United States), Sep 2002, 62(3) p986-96
AUTHOR(S): Clermont G; Acker CG; Angus DC; Sirio CA; Pinsky MR; Johnson JP
AUTHOR'S ADDRESS: Department of Critical Care Medicine and Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
PUBLICATION TYPE: Journal Article
ABSTRACT: Renal failure in the ICU: Comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes. CONCLUSIONS: Acute renal failure (ARF) is common in ICU patients and has a persistent negative impact on outcomes, although the majority of ARF is not severe enough to require dialysis support. The mortality of patients with ARF from all causes is almost exactly similar to that noted using the same criteria two decades ago. More profound ARF requiring dialysis continues to have an even greater mortality. Nevertheless, acute declines in renal function are associated with a mortality that is not well explained simply by loss of organ function. The majority of ARF patients who did not require dialysis still had a considerably higher mortality than the end-stage renal disease (ESRD) patients, all of whom required dialysis; while ARF patients who did require dialysis had a much higher morality than ESRD patients. APACHE III performs well and captures the mortality of patients with ARF at the time of scoring. Development of ARF after scoring has a profound effect on standardized mortality. We were unable to identify a unique mortality associated with ARF, but the presence of measurable renal insufficiency continues to be a sensitive marker for poor outcome.

ARTICLE TITLE: Five preventable causes of kidney graft loss in the 1990s: A single-center analysis
ARTICLE SOURCE: Kidney Int (United States), Aug 2002, 62(2) p704-14
AUTHOR(S): Matas AJ; Humar A; Gillingham KJ; Payne WD; Gruessner RW; Kandaswamy R; Dunn DL; Najarian JS; Sutherland DE
AUTHOR'S ADDRESS: Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
PUBLICATION TYPE: Journal Article
RESULTS: Five major causes of graft loss were noted in the 1990s: thrombosis, acute rejection (either alone or combined with delayed graft function or infection), chronic rejection, death with function, and noncompliance. In the first year post-transplant, thrombosis (25%) and death with function (41%) were the major causes of graft loss. After the first year, chronic rejection and death with function predominated. For recipients dying with graft function, cardiovascular disease was the major cause of death.

ARTICLE TITLE: Vascular access and increased risk of death among hemodialysis patients
ARTICLE SOURCE: Kidney Int (United States), Aug 2002, 62(2) p620-6
AUTHOR(S): Pastan S; Soucie JM; McClellan WM
AUTHOR'S ADDRESS: Renal Division, Department of Medicine, and Department of Epidemiology, Rollins School of Public Health,Emory University, Atlanta, Georgia, USA.
PUBLICATION TYPE: Journal Article
CONCLUSION: Venous catheters are associated with an increased risk of all-cause and infection-related mortality among hemodialysis patients.

ARTICLE TITLE: Modest serum creatinine elevation affects adverse outcome after general surgery
ARTICLE SOURCE: Kidney Int (United States), Aug 2002, 62(2) p585-92
AUTHOR(S): O'Brien MM; Gonzales R; Shroyer AL; Grunwald GK; Daley J; Henderson WG; Khuri SF; Anderson RJ
AUTHOR'S ADDRESS: Division of Cardiac Research, Denver Veterans Affairs Medical Center, and Division of General Internal Medicine,University of Colorado Health Sciences Center, Denver, Colorado, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Modest preoperative serum creatinine elevation (>1.5 mg/dL) is a significant predictor of risk-adjusted morbidity and mortality after general surgery. A preoperative serum creatinine of 1.5 mg/dL or higher is a readily available marker for potential adverse outcomes after general surgery.
MB: This is an association.

ARTICLE TITLE: Hyperkalemia: An adaptive response in chronic renal insufficiency
ARTICLE SOURCE: Kidney Int (United States), Jul 2002, 62(1) p1-9
AUTHOR(S): Gennari FJ; Segal AS
AUTHOR'S ADDRESS: University of Vermont College of Medicine, Burlington, Vermont, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: We propose that hyperkalemia plays a pivotal role in K+ homeostasis in renal insufficiency by stimulating K+ excretion. In patients with chronic renal insufficiency, a new steady state develops in which extracellular [K+] rises to the level needed to stimulate K+ excretion so that it again matches intake. When this new steady state is achieved, plasma [K+] remains stable unless dietary intake increases, glomerular filtration rate falls, or drugs are given that disrupt the new balance.
MB: I suppose they mean that you can get the K+ out with a smaller urinary flow with a higher serum K+. Like CO2 when the Pa CO2 is higher.

ARTICLE TITLE: In pursuit of the ideal liver allocation model
ARTICLE SOURCE: Liver Transpl (United States), Sep 2002, 8(9) p799-801
AUTHOR(S): Freeman RB
AUTHOR'S ADDRESS: Division of Transplantation, Tufts University School of Medicine, New England Medical Center, Boston, MA.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Auxiliary liver transplantation for fulminant hepatitis B: Results from a series of six patients with special emphasis on regeneration and recurrence of hepatitis B
ARTICLE SOURCE: Liver Transpl (United States), Aug 2002, 8(8) p701-7
AUTHOR(S): Durand F; Belghiti J; Handra-Luca A; Francoz C; Sauvanet A; Marcellin P; Farges O; Bernuau J; Valla D
AUTHOR'S ADDRESS: Service d'Hepatologie and INSERM U481, Hopital Beaujon, Clichy, France.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Reduced use of intensive care after liver transplantation: Influence of early extubation
ARTICLE SOURCE: Liver Transpl (United States), Aug 2002, 8(8) p676-81
AUTHOR(S): Mandell MS; Lezotte D; Kam I; Zamudio S
AUTHOR'S ADDRESS: Departments of Anesthesiology, University of Colorado Health Sciences Center, Denver, CO.
PUBLICATION TYPE: Journal Article
We therefore conclude that the majority of liver transplant recipients can be extubated safely and admitted to the surgical ward after liver transplantation surgery, thus decreasing the cost associated with ICU care.

ARTICLE TITLE: Fast track anesthesia for liver transplantation reduces postoperative ventilation time but not intensive care unit stay
ARTICLE SOURCE: Liver Transpl (United States), Aug 2002, 8(8) p670-5
AUTHOR(S): Findlay JY; Jankowski CJ; Vasdev GM; Chantigian RC; Gali B; Kamath GS; Keegan MT; Hall BA; Jones KA; Burkle CM; Plevak DJ
AUTHOR'S ADDRESS: Department of Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN 55905, USA.
PUBLICATION TYPE: Journal Article
We conclude that a fast track approach to anesthetic care reduces the requirement for postoperative mechanical ventilation, but does not reduce intensive care unit stay after liver transplantation.

ARTICLE TITLE: Metabolic, cardiovascular, and acid-base status after hepatic artery or portal vein reperfusion during orthotopic liver transplantation
ARTICLE SOURCE: Liver Transpl (United States), Jun 2002, 8(6) p537-44
AUTHOR(S): Walsh TS; Garden OJ; Lee A
AUTHOR'S ADDRESS: Departments of Clinical and Surgical Sciences, and the Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Scotland.
PUBLICATION TYPE: Journal Article
These observational data suggest that hepatic arterial reperfusion may be associated with reduced epinephrine requirements and a slower rate of acid release, which could be advantageous in unstable patients. Oxygen consumption (VO(2))increases more slowly after hepatic artery reperfusion, which could indicate slower reoxygenation of the graft. Further studies of the relative merits of each technique are warranted.

ARTICLE TITLE: The control of meningococcal disease
ARTICLE SOURCE: Med J Aust (Australia), Jun 17 2002, 176(12) p573-4
AUTHOR(S): Hall RG
AUTHOR'S ADDRESS: Communicable Disease Control, Department of Human Services, Adelaide, SA, Australia.
PUBLICATION TYPE: Editorial
ABSTRACT: Rapid treatment of people believed to be infected, and chemoprophylaxis of all close contacts, are the essentials of both immediate and broader public health management of this disease.

ARTICLE TITLE: Fire ants in Australia: a new medical and ecological hazard.
COMMENTS: Comment On: Comment On: RefSource:Med J Aust. 2002 Jun 3; 176(11):521-3
ARTICLE SOURCE: Med J Aust (Australia), Jun 3 2002, 176(11) p518-9
AUTHOR(S): McCubbin KI; Weiner JM
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Bushfires, air pollution and asthma.
COMMENTS: Comment On: Comment On: RefSource:Med J Aust. 2002 Jun 3; 176(11):535-8
ARTICLE SOURCE: Med J Aust (Australia), Jun 3 2002, 176(11) p517
AUTHOR(S): Lewis PR; Corbett SJ
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Antibiotic guidelines: improved implementation is the challenge.
COMMENTS: Comment On: Comment On: RefSource:Med J Aust. 2002 Jun 3; 176(11):524-9
ARTICLE SOURCE: Med J Aust (Australia), Jun 3 2002, 176(11) p513-4
AUTHOR(S): Watson DA
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Maternal deaths in Australia.
ARTICLE SOURCE: Med J Aust (Australia), May 6 2002, 176(9) p413-4
AUTHOR(S): Walters WA; Ford JB; Sullivan EA; King JF
PUBLICATION TYPE: Editorial
The 1994 -;1996 Australian maternal mortality ratio was 13.0 per 100 000 confinements, compared with the 1991&ndash;1993 ratio of
10.9 per 100 000 confinements. In the 1994&ndash;1996 triennium, there were 100 maternal deaths, of which 46 (46%) were direct deaths, 20 (20%) were indirect deaths and 34 (34%) were incidental in nature. This represented an increase of 19% in the number of deaths compared with the 1991&ndash;1993 triennium.The increase in deaths occurred almost exclusively in the direct deaths category: 27 (32%) direct deaths were reported in the 1991&ndash;1993 triennium, compared with 46 (46%) direct deaths in 1994&ndash;1996.There was an increase in the proportion of direct maternal deaths in which avoidable factors were considered to be possibly or certainly present from 7 (26%) of 27 deaths in 1991&ndash;1993 to 22 (48%) of 46 deaths in 1994&ndash;1996. The principal causes of direct maternal deaths remained pulmonary embolism (8 deaths [17%]), amniotic fluid embolism (8 deaths [17%]) and pre-eclampsia (6 deaths [13%]). Cardiorespiratory disease was the most common cause of indirect maternal death, with 10 (50%) indirect deaths falling into this category, while the leading causes of incidental death were injuries (16 deaths [47%]), neoplasms (5 deaths [15%]) and cerebrovascular disease (4 deaths [12%]).The Indigenous maternal mortality ratio (34.8 deaths per 100 000 confinements) remains about three times that of the non-Indigenous maternal mortality ratio (10.1 deaths per 100 000 confinements).

ARTICLE TITLE: Projections of Australian obstetricians ceasing practice and the reasons.
ARTICLE SOURCE: Med J Aust (Australia), May 6 2002, 176(9) p425-8
AUTHOR(S): MacLennan AH; Spencer MK
AUTHOR'S ADDRESS: Department of Obstetrics and Gynaecology, The University of Adelaide, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA 5006. alastair.maclennan@adelaide.edu.au.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Mechanism of chloride deficit in the maintenance of metabolic alkalosis
ARTICLE SOURCE: Nephron (Switzerland), Jul 2002, 91(3) p379-82
AUTHOR(S): Oh MS; Carroll HJ
AUTHOR'S ADDRESS: Department of Medicine, State University of New York, Health Science Center at Brooklyn, N.Y., USA.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Acute spontaneous spinal epidural hematoma in a hemodialysis patient with a bleeding tendency [In Process Citation]
ARTICLE SOURCE: Nephron (Switzerland), Jun 2002, 91(2) p358-60
AUTHOR(S): Sung JM; Hsieh CC; Yu CY; Huang JJ
AUTHOR'S ADDRESS: Division of Nephrology, Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.
PUBLICATION TYPE: Journal Article
MB: Bad luck.

ARTICLE TITLE: Unidimensional pain rating scales: a multidimensional affect and pain survey (MAPS) analysis of what they really measure
ARTICLE SOURCE: Pain (Netherlands), Aug 2002, 98(3) p241-7
AUTHOR(S): Crawford Clark W; Yang JC; Tsui SL; Ng KF; Bennett Clark S
AUTHOR'S ADDRESS: Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, 10032, New York, NY, USA.
PUBLICATION TYPE: Journal Article
ABSTRACT: Pain is now regarded as 'the fifth vital sign' and patients are frequently asked to score the intensity of their pain on a numerical pain rating scale (NPRS). However, the use of a unidimensional scale is questionable in view of the belief, overwhelmingly supported by clinical experience as well as by empirical evidence from multidimensional scaling and other sources, that pain has at least two dimensions: somatosensory qualities and affect. We used a Chinese translation of the 101 descriptor multidimensional affect and pain survey (MAPS) questionnaire to determine the relative contributions of various dimensions of postoperative pain to a patient's score on a unidimensional NPRS. MAPS and NPRS were administered postoperatively to 69 patients with descending colon carcinoma who were recovering from left hemi-colectomy. Multiple linear regression revealed that the emotional pain qualities supercluster (P=0.0005) and four of its eight subclusters, anxiety, depressed mood, fear and anger, significantly (P=0.001-0.007) predicted a patient's score on the unidimensional NPRS. Notably, none of the 17 subclusters in the somatosensory pain qualities supercluster predicted NPRS scores. It may be concluded that patient scores on unidimensional pain intensity scales reflect the emotional qualities of pain much more than its sensory intensity or other qualities. Accordingly such scales are poor indicators of analgesic requirement. The results also suggest that patients' postoperative anxiety and depression are inadequately treated. Based on our findings we present six unidimensional scales that should yield a more accurate assessment of the sources of a patient's pain.
MB: This is what happens if you try to measure pain. I have left the whole abstract in to show how hopeless the topic is.

ARTICLE TITLE: Pain elicited by blunt pressure: neurobiological basis and clinical relevance
ARTICLE SOURCE: Pain (Netherlands), Aug 2002, 98(3) p235-40
AUTHOR(S): Treede RD; Rolke R; Andrews K; Magerl W
AUTHOR'S ADDRESS: Institute of Physiology and Pathophysiology, Johannes Gutenberg University, Saarstrasse 21, D-55099, Mainz, Germany.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Reproducibility of pain measurement and pain perception
ARTICLE SOURCE: Pain (Netherlands), Jun 2002, 98(1-2) p205-16
AUTHOR(S): Rosier EM; Iadarola MJ; Coghill RC
AUTHOR'S ADDRESS: Pain and Neurosensory Mechanisms Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, 20892, Bethesda, MD, USA.
PUBLICATION TYPE: Journal Article
MB: I does not sound to me to be reproducible. Look at the full thing if you are interested.

ARTICLE TITLE: Detecting deception in pain expressions: the structure of genuine and deceptive facial displays
ARTICLE SOURCE: Pain (Netherlands), Jun 2002, 98(1-2) p135-44
AUTHOR(S): Hill ML; Craig KD
AUTHOR'S ADDRESS: Arthritis Institute, St. Joseph's Hospital, 268 Grosvenor St, P.O. Box 5777, Ontario, N6A 4V2, London, Canada.
PUBLICATION TYPE: Journal Article
<snip>. The differences between masked pain and neutral expressions were subtle, with a greater frequency of mouth opening and residual eyebrow movement in masked pain expressions. Thus, there is an empirical basis for discriminating genuine and deceptive facial displays.
MB: This is hopeless.

ARTICLE TITLE: Gender, coping and the perception of pain
ARTICLE SOURCE: Pain (Netherlands), Jun 2002, 97(3) p195-201
AUTHOR(S): Keogh E; Herdenfeldt M
AUTHOR'S ADDRESS: Department of Psychology, Goldsmiths College, University of London, New Cross, SE14 6NW, London, UK.
PUBLICATION TYPE: Journal Article
<snip> Compared to females, males exhibited less negative pain responses when focusing on the sensory component of pain (i.e. increased threshold, tolerance and lower sensory pain). Furthermore, compared to sensory focusing, emotional focusing was found to increase the affective pain experience of females. Together these results confirm that important differences exist between men and women in the effects pain coping instructions have on the experience of pain. The implications of such findings for research and practice are discussed.

ARTICLE TITLE: Translational pain research: bridging the gap between basic and clinical research
ARTICLE SOURCE: Pain (Netherlands), Jun 2002, 97(3) p183-7
AUTHOR(S): Mao J
AUTHOR'S ADDRESS: Department of Anesthesia and Critical Care, MGH Pain Center, Massachusetts General Hospital, Harvard Medical School, 02114, Boston, MA, USA.
PUBLICATION TYPE:Journal Article

ARTICLE TITLE: Cardiovascular effects of cannabinoids
ARTICLE SOURCE: Pharmacol Ther (England), Aug 2002, 95(2) p191
AUTHOR(S): Randall M; Harris D; Kendall D; Ralevic V
AUTHOR'S ADDRESS: School of Biomedical Sciences, University of Nottingham Medical School, Queen's Medical Centre, NG7 2UH, Nottingham, UK.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: From cannabis to cannabinergics. new therapeutic opportunities
ARTICLE SOURCE: Pharmacol Ther (England), Aug 2002, 95(2) p103
AUTHOR(S): Goutopoulos A; Makriyannis A
AUTHOR'S ADDRESS: Serono Reproductive Biology Institute, One Technology Place, 02370, Rockland, MA, USA.
PUBLICATION TYPE: Journal Article