ARTICLE TITLE: The effects of ropivacaine hydrochloride on
coagulation and fibrinolysis. An assessment using
thromboelastography.
ARTICLE SOURCE: Anaesthesia (England), Sep 1999, 54(9) p902-6
AUTHOR(S): Porter JM; McGinley J; O'Hare B; Shorten GD
AUTHOR'S ADDRESS: Department of Anaesthesia & Intensive Care
Medicine, Cork University Hospital, University College Cork, Wilton,
Cork, Republic of Ireland.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE
We conclude that it is unlikely that the presence of ropivacaine in
the epidural space would reduce the efficacy of an early or
prophylactic epidural blood patch.
MB. A pretty silly experiment.
ARTICLE TITLE: Antiseptic-bonded central venous catheters and
bacterial colonisation.
ARTICLE SOURCE: Anaesthesia (England), Sep 1999, 54(9) p868-72
AUTHOR(S): Hannan M; Juste RN; Umasanker S; Glendenning A;
Nightingale C; Azadian B; Soni N
AUTHOR'S ADDRESS: Department of Medical Microbiology, Imperial
College School of Medicine, Westminster Hospital, 369 Fullham Road,
London SW10 9NH, UK.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
Our results indicate that the use of antiseptic-bonded catheters in
critically ill patients significantly reduces the incidence of
bacterial colonisation.
ARTICLE TITLE: Poor anaesthetist hygienic practices - a problem
across all grades of anaesthetist [letter]
ARTICLE SOURCE: Anaesthesia (England), Jul 1999, 54(7) p718-9
AUTHOR(S): McNamara JT; Stacey SG
PUBLICATION TYPE: LETTER
MB. They have great faith in gloves. There is no mention of the blood
on gloves which I see every day.---or blood on central lines
connections etc.
ARTICLE TITLE: The story of the gauge.
ARTICLE SOURCE: Anaesthesia (England), Jun 1999, 54(6) p575-81
AUTHOR(S): Poll JS
AUTHOR'S ADDRESS: Haaglanden Medical Centre, Westeinde Hospital, PO
Box 432, 2501 CK The Hague, The Netherlands.
PUBLICATION TYPE: HISTORICAL ARTICLE; JOURNAL ARTICLE
ABSTRACT: Gauges are old measures of thickness. They originated in
the British iron wire industry at a time when there was no universal
unit of thickness. The sizes of the gauge numbers were the result of
the process of wire-drawing and the nature of iron as a substance.
Gauges were measured and described in fractions of an inch during the
19th century. In the UK, one gauge was standardised and legally
enforced as the Standard Wire Gauge. One important reason for the
standardisation of the gauge was the convenience of craftsmen. In the
20th century, the gauge was to be replaced with the introduction of
the International System of Units. However, within the field of
anaesthesia at the threshold of the 21st century, the gauge seems
hard to remove from the minds of craftsmen like anaesthetists.
MB. Please can we change to milli- or micrometres.
ARTICLE TITLE: Clinical Governance--what is it all about?
[editorial]
ARTICLE SOURCE: Anaesthesia (England), Apr 1999, 54(4) p311-2
AUTHOR(S): Morris GN; Johnson RW
PUBLICATION TYPE: EDITORIAL
ARTICLE TITLE: Anaesthesia.
ARTICLE SOURCE: BMJ (England), Aug 28 1999, 319(7209) p557-60
AUTHOR(S): Fox AJ; Rowbotham DJ
AUTHOR'S ADDRESS: University Department of Anaesthesia, University of
Leicester, Leicester Royal Infirmary, Leicester LE1 5WW.
MAJOR SUBJECT HEADING(S): Anesthesia [trends]
MINOR SUBJECT HEADING(S): Anesthesia, Epidural; Anesthesia,
Inhalation; Anesthesia, Intravenous; Anesthetics, Local; Laryngeal
Masks; Laryngoscopy [instrumentation]; Nausea
[etiology]; Vomiting [etiology]
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (41 references); REVIEW,
TUTORIAL
ARTICLE TITLE: Epidural anaesthesia and analgesia: better outcome
after major surgery?. Growing evidence suggests so
[editorial]
ARTICLE SOURCE: BMJ (England), Aug 28 1999, 319(7209) p530-1
AUTHOR(S): Buggy DJ; Smith G
PUBLICATION TYPE: EDITORIAL
MB. Even the enthusiastic misleading title is not reflected in the
substance of the editorial.
ARTICLE TITLE: Hyponatraemia after orthopaedic surgery
[editorial]
ARTICLE SOURCE: BMJ (England), May 22 1999, 318(7195) p1363-4
AUTHOR(S): Lane N; Allen K
MAJOR SUBJECT HEADING(S): Hyponatremia [etiology];
Orthopedics; Postoperative Complications [etiology]
PUBLICATION TYPE: EDITORIAL
ARTICLE TITLE: Hyponatraemia after orthopaedic surgery. Hypotonic
solutions should be used infrequently [letter] (MB about
above editorial)
ARTICLE SOURCE: BMJ (England), Aug 21 1999, 319(7208) p515-6
AUTHOR(S): Hoffbrand B
PUBLICATION TYPE: LETTER
MB. Emphasising again that fluid retention in operative
patients is not inappropriate ADH and that giving hypotonic fluid
especially to LOLs especially if they are on diuretics can still be
lethal. They quote an article of their own from the 1970s.
ARTICLE TITLE: Methods in health service research. An introduction
to bayesian methods in health technology assessment.
ARTICLE SOURCE: BMJ (England), Aug 21 1999, 319(7208) p508-12
AUTHOR(S): Spiegelhalter DJ; Myles JP; Jones DR; Abrams KR
AUTHOR'S ADDRESS: MRC Biostatistics Unit, Institute of Public Health,
Cambridge CB2 2SR. spieghalter@mrc-bsu.cam.ac.uk.
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (29 references); REVIEW,
TUTORIAL
ARTICLE TITLE: Mercury poisoning after spillage at home from a
sphygmomanometer on loan from hospital.
ARTICLE SOURCE: BMJ (England), Aug 7 1999, 319(7206) p366-7
AUTHOR(S): Rennie AC; McGregor-Schuerman M; Dale IM; Robinson C;
McWilliam R
AUTHOR'S ADDRESS: Royal Hospital for Sick Children, Yorkhill NHS
Trust, Glasgow G3 8SJ. alisonrennie@compuserve.com.
PUBLICATION TYPE: JOURNAL ARTICLE
ARTICLE TITLE: Bullying behaviour and psychosocial health among
school students in New South Wales, Australia: cross sectional survey
[see comments]
COMMENTS: Comment in: BMJ 1999 Aug 7; 319(7206):330-1
ARTICLE SOURCE: BMJ (England), Aug 7 1999, 319(7206) p344-8
AUTHOR(S): Forero R; McLellan L; Rissel C; Bauman A
AUTHOR'S ADDRESS: Health Promotion Unit, Liverpool Hospital,
Liverpool, New South Wales 2070, Australia.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: Being bullied seems to be widespread in schools in New
South Wales and is associated with increased psychosomatic symptoms
and poor mental health. Health practitioners evaluating students with
common psychological and psychosomatic symptoms should consider
bullying and the student's school environment as potential
causes.
MB. Close to us. L
ARTICLE TITLE: Bullying: the need for an interagency response.
Bullying is a social as well as an individual problem [editorial;
comment]
COMMENTS: Comment on: BMJ 1999 Aug 7; 319(7206):344-8; Comment on:
BMJ 1999 Aug 7; 319(7206):348-51
ARTICLE SOURCE: BMJ (England), Aug 7 1999, 319(7206) p330-1
AUTHOR(S): Chesson R
PUBLICATION TYPE: COMMENT; EDITORIAL
ARTICLE TITLE: ABC of intensive care. Withdrawal of treatment.
ARTICLE SOURCE: BMJ (England), Jul 31 1999, 319(7205) p306-8
AUTHOR(S): Winter B; Cohen S
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (0 references); REVIEW,
TUTORIAL
ARTICLE TITLE: Review of randomised controlled trials of
traditional Chinese medicine.
ARTICLE SOURCE: BMJ (England), Jul 17 1999, 319(7203) p160-1
AUTHOR(S): Tang JL; Zhan SY; Ernst E
AUTHOR'S ADDRESS: Department of Community and Family Medicine,
Chinese University of Hong Kong, Shatin, New Territories, Hong
Kong.
PUBLICATION TYPE: JOURNAL ARTICLE
ARTICLE TITLE: ABC of intensive care. Renal support.
ARTICLE SOURCE: BMJ (England), Jul 3 1999, 319(7201) p41-4
AUTHOR(S): Short A; Cumming A
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (0 references); REVIEW,
TUTORIAL
MB. Not very useful. They advise to get help from a senior
appropriately trained specialist. I would have thought the article
should have contained that help.
ARTICLE TITLE: British Hypertension Society guidelines for
hypertension management 1999: summary [see comments]
COMMENTS: Comment in: BMJ 1999 Sep 4; 319(7210):589-90
ARTICLE SOURCE: BMJ (England), Sep 4 1999, 319(7210) p630-5
AUTHOR(S): Ramsay LE; Williams B; Johnston GD; MacGregor GA; Poston
L; Potter JF; Poulter NR; Russell G
AUTHOR'S ADDRESS: University of Sheffield, Sheffield S10 2TN.
PUBLICATION TYPE: GUIDELINE; JOURNAL ARTICLE; PRACTICE GUIDELINE
ARTICLE TITLE: British guidelines on managing hypertension.
Provide evidence, progress, and an occasional missed opportunity
[editorial; comment]
COMMENTS: Comment on: BMJ 1999 Sep 4; 319(7210):630-5
ARTICLE SOURCE: BMJ (England), Sep 4 1999, 319(7210) p589-90
AUTHOR(S): Psaty BM; Furberg CD .
PUBLICATION TYPE: COMMENT; EDITORIAL
ARTICLE TITLE: Phantoms in the brain. Question the assumption that
the adult brain is "hard wired" [editorial]
ARTICLE SOURCE: BMJ (England), Sep 4 1999, 319(7210) p587-8
AUTHOR(S): Halligan PW; Zeman A; Berger A
PUBLICATION TYPE: EDITORIAL
ARTICLE TITLE: Immunomodulatory aspects of transfusion: a once and
future risk?
ARTICLE SOURCE: Anesthesiology (United States), Sep 1999, 91(3)
p861-5
AUTHOR(S): Klein HG
AUTHOR'S ADDRESS: Department of Transfusion Medicine, Warren G.
Magnuson Clinical Center, National Institutes of Health, Bethesda,
Maryland 20892-1184, USA. hklein@dtm.cc.nih.gov.
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (15 references); REVIEW,
TUTORIAL
ARTICLE TITLE: Preoxygenation: best method for both efficacy and
efficiency [editorial; comment]
COMMENTS: Comment on: Anesthesiology 1999 Sep; 91(3):612-6
ARTICLE SOURCE: Anesthesiology (United States), Sep 1999, 91(3)
p603-5
AUTHOR(S): Benumof JL
PUBLICATION TYPE: COMMENT; EDITORIAL
MB. Hardly worth the effort to find out.
ARTICLE TITLE: Spontaneous recovery after discontinuation of
cardiopulmonary resuscitation [letter]
ARTICLE SOURCE: Anesthesiology (United States), Aug 1999, 91(2)
p585-6
AUTHOR(S): MacGillivray RG
PUBLICATION TYPE: LETTER
ARTICLE TITLE: Recovery after discontinuation of cardiopulmonary
resuscitation ("Lazarus phenomenon") [letter]
ARTICLE SOURCE: Anesthesiology (United States), Aug 1999, 91(2)
p584-5
AUTHOR(S): Maleck WH; Piper SN
PUBLICATION TYPE: LETTER
MB. I have known of a few. In those instances I think that stopping
the excited bagging has been a factor. I have cured a few brick wall
bronchospasm by taking the reservoir bag from the frantic
anaesthetist.
ARTICLE TITLE: The American Society of Anesthesiologists Closed
Claims Project: what have we learned, how has it affected practice,
and how will it affect practice in the future?
ARTICLE SOURCE: Anesthesiology (United States), Aug 1999, 91(2)
p552-6
AUTHOR(S): Cheney FW
AUTHOR'S ADDRESS: Department of Anesthesiology, University of
Washington School of Medicine, Seattle 98195, USA.
fcheney@u.washington.edu.
PUBLICATION TYPE: JOURNAL ARTICLE
ARTICLE TITLE: Pain: the past, present, and future of
anesthesiology? The E. A. Rovenstine Memorial Lecture.
ARTICLE SOURCE: Anesthesiology (United States), Aug 1999, 91(2)
p538-51
AUTHOR(S): Cousins MJ
AUTHOR'S ADDRESS: Department of Anaesthesia & Pain Management,
University of Sydney Pain Management & Research Centre, Royal
North Shore Hospital, New South Wales, Australia.
mcousins@doh.health.nsw.gov.au.
PUBLICATION TYPE: LECTURES
ARTICLE TITLE: The effect of prophylactic epsilon-aminocaproic
acid on bleeding, transfusions, platelet function, and fibrinolysis
during coronary artery bypass grafting.
ARTICLE SOURCE: Anesthesiology (United States), Aug 1999, 91(2)
p430-5
AUTHOR(S): Troianos CA; Sypula RW; Lucas DM; D'Amico F; Mathie TB;
Desai M; Pasqual RT; Pellegrini RV; Newfeld ML
AUTHOR'S ADDRESS: Department of Anesthesiology, The Mercy Hospital of
Pittsburgh, Pennsylvania 15219, USA. ctroianos@mercy.pmhs.org.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
CONCLUSIONS: Prophylactic administration of epsilon-ACA after
heparinization but before cardiopulmonary bypass is of minimal
benefit for reducing blood loss postoperatively in patients
undergoing primary coronary artery bypass grafting.
ARTICLE TITLE: Relative contribution of skin and core temperatures
to vasoconstriction and shivering thresholds during isoflurane
anesthesia.
ARTICLE SOURCE: Anesthesiology (United States), Aug 1999, 91(2)
p422-9
AUTHOR(S): Lenhardt R; Greif R; Sessler DI; Laciny S; Rajek A;
Bastanmehr H
AUTHOR'S ADDRESS: Department of Anesthesia and Perioperative Care,
University of California, San Francisco 94143-0648, USA.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
CONCLUSIONS: The results in anesthetized volunteers were virtually
identical to those reported previously in unanesthetized subjects. In
both cases, the cutaneous contribution to control of vasoconstriction
and shivering was linear and near 20%. These data indicate that a
proportionality constant of approximately 20% can be used to
compensate for experimentally induced skin-temperature manipulations
in anesthetized as well as unanesthetized subjects.
ARTICLE TITLE: Platelet-activated clotting time does not measure
platelet reactivity during cardiac surgery.
ARTICLE SOURCE: Anesthesiology (United States), Aug 1999, 91(2)
p362-8
AUTHOR(S): Shore-Lesserson L; Ammar T; De Perio M; Vela-Cantos F;
Fisher C; Sarier K
AUTHOR'S ADDRESS: Department of Cardiothoracic Anesthesiology, The
Mount Sinai Medical Center, New York, New York, USA.
linda_shore@SMTPLINK.mssm.edu.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: The platelet dysfunction associated with CPB may be a
result of depressed platelet reactivity, as shown by thrombin
receptor activating peptide-induced P-selectin expression. Changes in
PACT did not correlate with blood loss or with changes in P-selectin
expression suggesting that PACT is not a specific measure of platelet
reactivity.
ARTICLE TITLE: Airway exchange catheters: simple concept,
potentially great danger [editorial; comment]
COMMENTS: Comment on: Anesthesiology 1999 Aug; 91(2):557-8
ARTICLE SOURCE: Anesthesiology (United States), Aug 1999, 91(2)
p342-4
AUTHOR(S): Benumof JL
PUBLICATION TYPE: COMMENT; EDITORIAL
MB.Blowing oxygen down an exchange catheter without an exit passage
can produce baratrauma. Surprise, surprise.
ARTICLE TITLE: Will we ever understand perioperative neuropathy? A
fresh approach offers hope and insight [editorial;
comment]
COMMENTS: Comment on: Anesthesiology 1999 Aug; 91(2):345-54
ARTICLE SOURCE: Anesthesiology (United States), Aug 1999, 91(2)
p335-6
AUTHOR(S): Caplan RA
PUBLICATION TYPE: COMMENT; EDITORIAL
ARTICLE TITLE: The relationship between the visual analog pain
intensity and pain relief scale changes during analgesic drug studies
in chronic pain patients.
ARTICLE SOURCE: Anesthesiology (United States), Jul 1999, 91(1)
p34-41
AUTHOR(S): Angst MS; Brose WG; Dyck JB
AUTHOR'S ADDRESS: Department of Anesthesia, Stanford University
School of Medicine, California 94305-5117, USA.
ang@leland.stanford.edu.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: The relationship between visual analog pain intensity
and pain relief scores changed systematically during both analgesic
drug studies. The authors hypothesize that patients' interpretation
of the pain relief scale had changed during the studies and therefore
suggest using the pain intensity scale to quantify analgesic drug
action over time.
MB. How can anyone think that you can measure pain by such
methods.
ARTICLE TITLE: Total blood transfusion and mortality after
orthotopic liver transplantation [letter]
ARTICLE SOURCE: Anesthesiology (United States), Jul 1999, 91(1)
p329-30
AUTHOR(S): Schroeder RA; Johnson LB; Plotkin JS; Kuo PC; Klein AS
PUBLICATION TYPE: LETTER
MB. I f a lot of blood is given a lot has been lost. Either the
operation is more difficult or the surgeon is not so good.
ARTICLE TITLE: Consistency, inter-rater reliability, and validity
of 441 consecutive mock oral examinations in anesthesiology:
implications for use as a tool for assessment of residents [see
comments]
COMMENTS: Comment in: Anesthesiology 1999 Jul; 91(1):4-6
ARTICLE SOURCE: Anesthesiology (United States), Jul 1999, 91(1)
p288-98
AUTHOR(S): Schubert A; Tetzlaff JE; Tan M; Ryckman JV; Mascha E
AUTHOR'S ADDRESS: Division of Anesthesiology and Critical Care
Medicine at the Cleveland Clinic Foundation, Ohio 44195, USA.
schubea@cesmtp.ccf.org.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSION: Our results show the substantial internal consistency and
reliability of OPE results at a single institution. The positive
correlation of OPE scores with in-training examination scores,
faculty evaluations, and other indicators of preparation suggest that
OPEs are a reasonably valid tool for assessment of resident
performance.
MB. It is an absolute standard we are after. It is not much good
having internal consistency only. If they are all consistent why use
multiple mthods.
ARTICLE TITLE: Oral practice examinations: are they worth it?
[editorial; comment]
COMMENTS: Comment on: Anesthesiology 1999 Jul; 91(1):288-98
ARTICLE SOURCE: Anesthesiology (United States), Jul 1999, 91(1)
p4-6
AUTHOR(S): James FM 3rd
PUBLICATION TYPE: COMMENT; EDITORIAL
ARTICLE TITLE: A matter of life and death: what every
anesthesiologist should know about the medical, legal, and ethical
aspects of declaring brain death [see comments]
COMMENTS: Comment in: Anesthesiology 1999 Jul; 91(1):3-4
ARTICLE SOURCE: Anesthesiology (United States), Jul 1999, 91(1)
p275-87
AUTHOR(S): Van Norman GA
AUTHOR'S ADDRESS: Department of Anesthesiology, University of
Washington, Seattle 98195, USA. gvn@u.washington.edu.
PUBLICATION TYPE: JOURNAL ARTICLE
As the cases presented here illustrate, anesthesiologists have an
important responsibility in the process of assuring that some living
patients are not sacrificed to benefit others. Criteria for declaring
death should be familiar to every anesthesiologist participating in
organ retrieval. Before accepting the responsibility of maintaining a
donor for vital organ collection, the anesthesiologist should review
data supplied in the chart supporting the diagnosis of brain death
and seriously question inconsistencies and inadequate testing
conditions. Knowledge of brain death criteria and proper application
of these criteria could have changed the course of each of the cases
presented.
ARTICLE TITLE: Can postoperative nausea and vomiting be
predicted?
ARTICLE SOURCE: Anesthesiology (United States), Jul 1999, 91(1)
p109-18
AUTHOR(S): Sinclair DR; Chung F; Mezei G
AUTHOR'S ADDRESS: Department of Anesthesia, Toronto Hospital,
University of Toronto, Ontario, Canada.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: A validated mathematical model is provided to calculate
the risk of PONV in outpatients having surgery. Knowing the factors
that predict PONV will help anesthesiologists determine which
patients will need antiemetic therapy.
ARTICLE TITLE: Regional anesthesia and postoperative pain
management: long-term benefits from a short-term intervention
COMMENTS: Comment on: Anesthesiology 1999 Jul; 91(1):8-15
ARTICLE SOURCE: Anesthesiology (United States), Jul 1999, 91(1)
p1-2
AUTHOR(S): Todd MM; Brown DL
PUBLICATION TYPE: COMMENT; EDITORIAL
MB. Don’t wait with baited breath.
ARTICLE TITLE: Improved survival following massive transfusion in
patients who have undergone trauma.
ARTICLE SOURCE: Arch Surg (United States), Sep 1999, 134(9) p964-8;
discussion 968-70
AUTHOR(S): Cinat ME; Wallace WC; Nastanski F; West J; Sloan S; Ocariz
J; Wilson SE
AUTHOR'S ADDRESS: Department of Surgery, University of California
Irvine Medical Center, Orange 92868, USA. mecinat@uci.edu.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: Survival following massive transfusion has significantly
(P = .03) increased during the past 10 years. Factors that may have
contributed to this include more effective and efficient rewarming
procedures, improved application of damage control techniques, more
aggressive correction of coagulopathy, and improved blood banking
procedures.
ARTICLE TITLE: Endovascular vs open abdominal aortic aneurysm
repair: a comparison of cardiac morbidity and mortality.
ARTICLE SOURCE: Arch Surg (United States), Sep 1999, 134(9) p947-50;
discussion 950-1
AUTHOR(S): de Virgilio C; Bui H; Donayre C; Ephraim L; Lewis RJ;
Elbassir M; Stabile BE; White R
AUTHOR'S ADDRESS: Department of Surgery, Harbor-UCLA Medical Center,
Torrance, Calif 90509, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: Patients undergoing endovascular abdominal aortic
aneurysm (EAAA) and open abdominal aortic aneurysm (OAAA) repair had
similar cardiac event rates and mortality. In patients undergoing
EAAA repair, history of congestive heart failure and Q wave on
electrocardiogram were predictors of cardiac events.
ARTICLE TITLE: Ultrasound-guided central venous access.
ARTICLE SOURCE: Arch Surg (United States), Jul 1999, 134(7) p738-40;
discussion 741
AUTHOR(S): Fry WR; Clagett GC; O'Rourke PT
AUTHOR'S ADDRESS: Department of Surgery, Penrose Hospital, Colorado
Springs, Colo., USA. williamfry@centura.org.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: Ultrasound-guided central venous access is a helpful
technique to gain venous access in difficult cases. Surgeons who
perform central venous access procedures should become acquainted
with the techniques involved. The techniques should be incorporated
into currently developing ultrasound instruction courses for
surgeons.
MB. Anaesthetists should use it too. I think that before any IJ
cannulation one should check with ultrasound.
ARTICLE TITLE: Therapeutic orphans [editorial]
ARTICLE SOURCE: Pediatrics (United States), Sep 1999, 104(3 Pt 2)
p583-4
AUTHOR(S): Shirkey H
PUBLICATION TYPE: EDITORIAL
ARTICLE TITLE: Sauna-induced myocardial ischemia in patients with
coronary artery disease [see comments]
COMMENTS: Comment in: Am J Med 1999 Sep; 107(3):290-2
ARTICLE SOURCE: Am J Med (United States), Sep 1999, 107(3)
p228-33
AUTHOR(S): Giannetti N; Juneau M; Arsenault A; Behr MA; Gregoire J;
Tessier M; Larivee L
AUTHOR'S ADDRESS: Department of Medicine, Montreal Heart Institute,
University of Montreal, Quebec, Canada.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSION: In patients with stable coronary artery disease, sauna
use is clinically well tolerated but is associated with
scintigraphically demonstrated myocardial ischemia.
ARTICLE TITLE: "If you can't stand the heat, get out of the
kitchen" [editorial; comment]
COMMENTS: Comment on: Am J Med 1999 Sep; 107(3):228-33
ARTICLE SOURCE: Am J Med (United States), Sep 1999, 107(3) p290-2
AUTHOR(S): Leppo JA
PUBLICATION TYPE: COMMENT; EDITORIAL
MB. Complaining about drugs not approved for children.
ARTICLE TITLE: Treatment of hepatitis C: a decision that needs
careful consideration [editorial; comment]
COMMENTS: Comment on: Am J Med 1999 Aug; 107(2):112-8
ARTICLE SOURCE: Am J Med (United States), Aug 1999, 107(2) p180-1
AUTHOR(S): Wright TL
MAJOR SUBJECT HEADING(S): Antiviral Agents [therapeutic use];
Hepatitis C-Like Viruses [drug effects]; Hepatitis C
[drug therapy]; Interferons [therapeutic use];
Ribavirin [therapeutic use]
MINOR SUBJECT HEADING(S): DNA, Viral [blood]; Disease
Progression; Drug Administration Schedule; Drug Therapy, Combination;
Hepatitis C-Like Viruses [genetics]; Risk
MB. A large number of our liver transplants are for this. There is a
big risk for us. Blood everywhere. Some of this is from the
anaesthetists. L
ARTICLE TITLE: A randomized trial of povidone-iodine compared with
iodine tincture for venipuncture site disinfection: effects on rates
of blood culture contamination.
ARTICLE SOURCE: Am J Med (United States), Aug 1999, 107(2)
p119-25
AUTHOR(S): Little JR; Murray PR; Traynor PS; Spitznagel E
AUTHOR'S ADDRESS: Division of Infectious Diseases, Washington
University School of Medicine, St. Louis, Missouri 63110-1093,
USA.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
CONCLUSIONS: Iodine tincture is superior to povidone-iodine for
venipuncture site antisepsis before blood culture sampling. Because
of the high costs associated with contaminated blood cultures,
hospitals should consider switching from povidone-iodine to iodine
tincture. Reduction of the contamination rate may improve the quality
of patient care and reduce hospital costs.
MB. I thought that tincture of iodine was obsolete.
ARTICLE TITLE: Evidence-based organ allocation.
ARTICLE SOURCE: Am J Med (United States), Jul 1999, 107(1) p52-61
AUTHOR(S): Zenios SA; Wein LM; Chertow GM
AUTHOR'S ADDRESS: Graduate School of Business, Stanford University,
CA, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: BACKGROUND: There are not enough cadaveric kidneys to meet
the demands of transplant candidates. The equity and efficiency of
alternative organ allocation strategies have not been rigorously
compared. METHODS: We developed a five-compartment Monte Carlo
simulation model to compare alternative organ allocation strategies,
accommodating dynamic changes in recipient and donor characteristics,
patient and graft survival rates, and quality of life. The model
simulated the operations of a single organ procurement organization
and attempted to predict the evolution of the transplant waiting list
for 10 years. Four allocation strategies were compared: a first-come
first-transplanted system; a point system currently utilized by the
United Network of Organ Sharing; an efficiency-based algorithm that
incorporated correlates of patient and graft survival; and a
distributive efficiency algorithm, which had an additional goal of
promoting equitable allocation among African-American and other
candidates. RESULTS: A 10-year computer simulation was performed. The
distributive efficiency policy was associated with a 3.5%+/-0.8%
(mean +/- SD) increase in quality-adjusted life expectancy (33.9
months vs 32.7 months), a decrease in the median waiting time to
transplantation among those who were transplanted (6.6 months vs 16.3
months), and an increase in the overall likelihood of transplantation
(61% vs 45%), compared with the United Network of Organ Sharing
algorithm. Improved equity and efficiency were also seen by race
(African-American vs other), sex, and age (<50 or > or =50
years). Sensitivity analyses did not appreciably change the
qualitative results. CONCLUSION: Evidence-based organ allocation
strategies in cadaveric kidney transplantation would yield improved
equity and efficiency measures compared with existing algorithms.
ARTICLE TITLE: Thermal injury with pulse oximeter probe in
hypothermic patient. Pulse oximeter probe burn in hypothermia
[letter]
ARTICLE SOURCE: Can J Anaesth (Canada), Sep 1999, 46(9) p908-9
AUTHOR(S): Pandey CK; Rani A; Srivastava K; Baronia A; Agarwal A
PUBLICATION TYPE: LETTER
ARTICLE TITLE: Intraoperative rupture of an abdominal aortic
aneurysm during an endovascular stent-graft procedure.
ARTICLE SOURCE: Can J Anaesth (Canada), Sep 1999, 46(9) p887-90
AUTHOR(S): Moskowitz DM; Kahn RA; Marin ML; Hollier LH
AUTHOR'S ADDRESS: Department of Anesthesiology, The Mount Sinai
Medical Center, New York, NY 10029, USA.
dmoskowitz@smtplink.mssm.edu.
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: PURPOSE: To highlight the risk of intraoperative rupture as
a complication of endovascular aortic repair. CLINICAL FEATURES: An
81-yr-old man was admitted for endovascular aortic repair of a 6 cm
infrarenal abdominal aortic aneurysm. After establishment of a
conduction blockade using a combined spinal-epidural technique, a
balloon-activated endovascular stent-graft was advanced to the
proximal aneurysmal neck. Approximately four minutes after the
stent-graft was deployed, the mean arterial pressure decreased to 30
mmHg and the heart rate increased to 135 bpm. While fluid and
vasoactive medications were administered and the airway was secured,
repeat aortography confirmed contrast extravasation into the
retroperitoneal space at the junction of the proximal aortic neck and
the aneurysm sac. The angioplasty deployment balloon was repositioned
and inflated proximal to the presumed site of aortic rupture, thus
providing aortic control until an open repair of the aorta was
undertaken. CONCLUSION: Although endovascular stent-graft placement
may be a less invasive method than conventional open aortic
reconstruction, it must be recognized that the potential for
devastating consequences such as aortic rupture is present.
MB. I can’t think why they decided to publish. It is obvious
that rupture can occur so that you should prepare as though it is
going to happen every time. ie Operating Room, GA, prepared abdomen,
blood available etc.
ARTICLE TITLE: Cost-effectiveness of prophylactic dolasetron or
droperidol vs rescue therapy in the prevention of PONV in ambulatory
gynecologic surgery.
ARTICLE SOURCE: Can J Anaesth (Canada), Jun 1999, 46(6) p536-43
AUTHOR(S): Frighetto L; Loewen PS; Dolman J; Marra CA
AUTHOR'S ADDRESS: Clinical Drug Research Program, CSU Pharmaceutical
Sciences, Vancouver Hospital and Health Sciences Centre, BC,
Canada.
INDEXING CHECK TAG(S): Comparative Study; Female; Human
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: Dolasetron and droperidol given intraoperatively were
more cost-effective than no prophylaxis for PONV in patients
undergoing ambulatory gynecologic surgery. The difference between the
two agents was small and favoured droperidol. The model was robust to
plausible changes through sensitivity analyses.
ARTICLE TITLE: Postoperative nausea and vomiting--when will it
stop? [editorial; comment]
COMMENTS: Comment on: Can J Anaesth 1999 Aug; 46(8):719-24
ARTICLE SOURCE: Can J Anaesth (Canada), Aug 1999, 46(8) p715-6
AUTHOR(S): Stockall CA
PUBLICATION TYPE: COMMENT; EDITORIAL
MB. Let’s give up.
ARTICLE TITLE: Covering the head and face maintains intraoperative
core temperature.
ARTICLE SOURCE: Can J Anaesth (Canada), Jul 1999, 46(7) p649-52
AUTHOR(S): Kamitani K; Higuchi A; Takebayashi T; Miyamoto Y; Yoshida
H
AUTHOR'S ADDRESS: Department of Anesthesia, Toyama Prefectural
Central Hospital, Nishinagae, Toyama City, Japan.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
ABSTRACT: PURPOSE: To determine the effect of covering the patient's
head and face on the prevention of intraoperative hypothermia
(<35.5 degrees C). METHODS: This randomized, prospective trial
included 44 adults undergoing elective abdominal surgery. After the
induction of anesthesia with thiopental, in 44 patients their
extremities and trunk were covered with towels and sheets. In
addition, 22 patients (covered group) had their face and head fully
covered. Anesthesia was maintained with N2O 50-66% (2-3 L x min(-1))
and isoflurane (<IMAC) in oxygen combined with thoracic epidural
anesthesia. Core temperature was measured at the tympanic membrane
continuously and was recorded at 15 min intervals from the induction
of anesthesia. Heat and moisture exchangers were used in their
anesthetic circuit. Ambient temperature was maintained near 25
degrees C. RESULTS: Neither group demonstrated intraoperative
hypothermia. However, tympanic membrane temperature at 75, 90, 105
min in the covered group were higher than those of control group
(36.7+/-0.4 degrees C vs. 36.5+/-0.4 degrees C, 36.8+/-0.5 degrees C
vs. 36.4+/-0.5 degrees C, 36.8+/-0.5 degrees C vs. 36.4+/-0.5 degrees
C, respectively, P<0.05). CONCLUSION: Covering the patient's head
and face maintains intraoperative core temperature.
MB. Cover everything, which they did and had room temp at 25C.
ARTICLE TITLE: Anesthesia and end stage renal failure: is TIVA an
advance? [editorial]
ARTICLE SOURCE: Can J Anaesth (Canada), Jul 1999, 46(7) p621-2
AUTHOR(S): Byrick RJ
PUBLICATION TYPE: EDITORIAL
MB. No.
ARTICLE TITLE: Perioperative cardiac arrest and resuscitation: do
we know what we're doing? [editorial; comment]
COMMENTS: Comment on: Can J Anaesth 1999 Jun; 46(6):529-35
ARTICLE SOURCE: Can J Anaesth (Canada), Jun 1999, 46(6) p519-24
AUTHOR(S): Bands C; Davies JM
PUBLICATION TYPE: COMMENT; EDITORIAL
MB. Some do and some don’t. The editorial thinks that none of
us know ‘cause we don’t practice enough. L
ARTICLE TITLE: Sexual orientation and youth suicide.
ARTICLE SOURCE: JAMA (United States), Oct 6 1999, 282(13) p1291-2
AUTHOR(S): Remafedi G
AUTHOR'S ADDRESS: University of Minnesota Medical School,
Minneapolis, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
ARTICLE TITLE: Harassment of lesbians as medical students and
physicians.
ARTICLE SOURCE: JAMA (United States), Oct 6 1999, 282(13) p1290,
1292
AUTHOR(S): Brogan DJ; Frank E; Elon L; Sivanesan SP; O'Hanlan KA
AUTHOR'S ADDRESS: Emory University, Atlanta, GA, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
ARTICLE TITLE: Adenoidectomy and adenotonsillectomy for recurrent
acute otitis media: parallel randomized clinical trials in children
not previously treated with tympanostomy tubes [see
comments]
COMMENTS: Comment in: JAMA 1999 Sep 8; 282(10):987-9
ARTICLE SOURCE: JAMA (United States), Sep 8 1999, 282(10) p945-53
AUTHOR(S): Paradise JL; Bluestone CD; Colborn DK; Bernard BS; Smith
CG; Rockette HE; Kurs-Lasky M
AUTHOR'S ADDRESS: Department of Pediatrics, Children's Hospital of
Pittsburgh, School of Medicine, University of Pittsburgh, PA
15213-3417, USA. jpar@pitt.edu. .
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
CONCLUSIONS: Our study showed limited and short-term efficacy of both
adenoidectomy and adenotonsillectomy; given the risks, morbidity, and
costs of these procedures, these data suggest that neither operation
should ordinarily be considered as a first surgical intervention in
children whose only indication is recurrent acute otitis media.
ARTICLE TITLE: Impact of formal continuing medical education: do
conferences, workshops, rounds, and other traditional continuing
education activities change physician behavior or health care
outcomes?
ARTICLE SOURCE: JAMA (United States), Sep 1 1999, 282(9) p867-74
AUTHOR(S): Davis D; O'Brien MA; Freemantle N; Wolf FM; Mazmanian P;
Taylor-Vaisey A
AUTHOR'S ADDRESS: Continuing Education and the Centre for Research in
Education, University of Toronto, Faculty of Medicine, Ontario,
Canada. dave.davis@utoronto.ca.
PUBLICATION TYPE: JOURNAL ARTICLE; META-ANALYSIS
CONCLUSIONS: Our data show some evidence that interactive CME
sessions that enhance participant activity and provide the
opportunity to practice skills can effect change in professional
practice and, on occasion, health care outcomes. Based on a small
number of well-conducted trials, didactic sessions do not appear to
be effective in changing physician performance.
MB. We don’t go to be trasnformed.
ARTICLE TITLE: Possible venous argon gas embolism complicating
argon gas enhanced coagulation during liver surgery.
ARTICLE SOURCE: Acta Anaesthesiol Scand (Denmark), Sep 1999, 43(8)
p866-7
AUTHOR(S): Stojeba N; Mahoudeau G; Segura P; Meyer C; Steib A
AUTHOR'S ADDRESS: Service d'anesthesie-reanimation, Hopitaux
universitaires de Strasbourg, Hopital de Hautepierre, France.
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: We report a case of a major venous argon embolism during
argon beam coagulation of a liver biopsy. The essential signs were an
abrupt reduction in end-tidal carbon dioxide partial pressure, in
SpO2 and in systolic arterial pressure, at the time of coagulation.
Spontaneous recovery was observed within 10 min. Precautions in
respect of usage are highlighted.
ARTICLE TITLE: The role of stress in anaesthetists' health and
well-being.
ARTICLE SOURCE: Acta Anaesthesiol Scand (Denmark), Jul 1999, 43(6)
p583-602
AUTHOR(S): Jackson SH
AUTHOR'S ADDRESS: Department of Anesthesiology, Good Samaritan
Hospital, San Jose, California, USA.
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (101 references); REVIEW,
TUTORIAL
ABSTRACT: Stress is an inevitable part of our personal and
professional lives. When poorly managed, stress will accumulate to
levels that become injurious to our health and well-being. Burnout is
one such consequence. However, because stress is an active process,
with the proper knowledge and skills, we can learn to better manage
and control its level of intensity. This paper examines the stress
cycle and especially those aspects that are unique to the practice of
medicine and anaesthesia. Sleep deprivation and physical fatigue are
analyzed as key stressors. The role of the medical marriage and
dual-career relationships are scrutinized. The importance of
retaining the humanistic essence of medicine is emphasized. Stress
management strategies and coping responses, including self-care and
humor, are discussed.
ARTICLE TITLE: Reduced ventilator pressure and improved P/F ratio
during percutaneous arteriovenous carbon dioxide removal for severe
respiratory failure.
ARTICLE SOURCE: Ann Surg (United States), Aug 1999, 230(2)
p215-24
AUTHOR(S): Alpard SK; Zwischenberger JB; Tao W; Deyo DJ; Bidani A
AUTHOR'S ADDRESS: Department of Surgery, University of Texas Medical
Branch and Shriners Burns Institute, Galveston 77555-0528, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: Percutaneous percutaneous arteriovenous carbon dioxide
removal (AVCO2R) allows near-total CO2 removal and significant
reductions in ventilator pressures with improvement in the P/F
ratio.
ARTICLE TITLE: Relation of surgical volume to outcome in eight
common operations: results from the VA National Surgical Quality
Improvement Program.
ARTICLE SOURCE: Ann Surg (United States), Sep 1999, 230(3) p414-29;
discussion 429-32
AUTHOR(S): Khuri SF; Daley J; Henderson W; Hur K; Hossain M; Soybel
D; Kizer KW; Aust JB; Bell RH Jr; Chong V; Demakis J; Fabri PJ; Gibbs
JO; Grover F; Hammermeister K; McDonald G; Passaro E Jr; Phillips L;
Scamman F; Spencer J; Stremple JF
AUTHOR'S ADDRESS: Brockton/West Roxbury VA Medical Center, MA 02132,
USA.
PUBLICATION TYPE: JOURNAL ARTICLE
METHODS: The VHA National Surgical Quality Improvement Program data
on nonruptured abdominal aortic aneurysmectomy, vascular
infrainguinal reconstruction, carotid endarterectomy (CEA), lung
lobectomy/pneumonectomy, open and laparoscopic cholecystectomy,
partial colectomy, and total hip arthroplasty were used. Pearson
correlation, analysis of variance, mixed effects hierarchical
logistic regression, and automatic interaction detection analysis
were used to assess the association of annual procedure/specialty
volume with risk-adjusted 30-day death (and stroke in CEA). RESULTS:
Eight major surgical procedures (68,631 operations) were analyzed. No
statistically significant associations between procedure or specialty
volume and 30-day mortality rate (or 30-day stroke rate in CEA) were
found. CONCLUSIONS: In VHA hospitals, the procedure and surgical
specialty volume in eight prevalent operations of intermediate
complexity are not associated with risk-adjusted 30-day mortality
rate from these operations, or with the risk-adjusted 30-day stroke
rate from CEA. Volume of surgery in these operations should not be
used as a surrogate for quality of surgical care.
ARTICLE TITLE: Hospital volume can serve as a surrogate for
surgeon volume for achieving excellent outcomes in colorectal
resection.
ARTICLE SOURCE: Ann Surg (United States), Sep 1999, 230(3) p404-11;
discussion 411-3
AUTHOR(S): Harmon JW; Tang DG; Gordon TA; Bowman HM; Choti MA;
Kaufman HS; Bender JS; Duncan MD; Magnuson TH; Lillemoe KD; Cameron
JL
AUTHOR'S ADDRESS: Department of Surgery, The Johns Hopkins University
School of Medicine, Baltimore, Maryland, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: A skewed distribution of case volumes by surgeon was
found in this study of patients who underwent resection for large
bowel cancer in Maryland. The majority of these surgeons performed
very few operations for colorectal cancer per year, whereas a
minority performed >10 cases per year. Medium-volume surgeons
achieved excellent outcomes similar to high-volume surgeons when
operating in medium-volume or high-volume hospitals, but not in
low-volume hospitals. The results of low-volume surgeons improved
with increasing hospital volume but never equaled those of the
high-volume surgeons.
ARTICLE TITLE: What have we learned about primary liver
transplantation under tacrolimus immunosuppression? Long-term
follow-up of the first 1000 patients.
ARTICLE SOURCE: Ann Surg (United States), Sep 1999, 230(3) p441-8;
discussion 448-9
AUTHOR(S): Jain A; Reyes J; Kashyap R; Rohal S; Abu-Elmagd K; Starzl
T; Fung J
AUTHOR'S ADDRESS: Thomas E. Starzl Transplantation Institute,
University of Pittsburgh, Pennsylvania, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: Long-term patient and graft survival rates are excellent
under tacrolimus immunosuppression. Pediatric patients have a better
long-term outcome than adults, in part because of the limited
recurrence of the original disease, which was the most common cause
of late graft loss (other than patient death, most commonly the
result of late de novo malignancies and cardiovascular events). Graft
loss from late rejection was rare.
ARTICLE TITLE: Withdrawal of haloperidol, thioridazine, and
lorazepam in the nursing home: a controlled, double-blind study.
ARTICLE SOURCE: Arch Intern Med (United States), Aug 9-23 1999,
159(15) p1733-40
AUTHOR(S): Cohen-Mansfield J; Lipson S; Werner P; Billig N; Taylor L;
Woosley R
AUTHOR'S ADDRESS: Research Institute of the Hebrew Home of Greater
Washington, Rockville, MD 20852, USA.
cohen-mansfield@hebrew-home.org.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
ABSTRACT: BACKGROUND: Ongoing regimens of haloperidol, thioridazine,
and lorazepam are commonly administered to manage behavior problems
in nursing home residents. Nevertheless, there is controversy over
whether periodic drug withdrawal should be attempted when those
medications are prescribed. This study addressed that issue by
examining the effects of discontinuing treatment with haloperidol,
thioridazine, and lorazepam among residents of a large suburban
nursing home. METHODS: In a double-blind, crossover study, half of 58
nursing home residents (43 women and 15 men with a mean age of 86
years) continued to take the psychotropic medication they had been
prescribed, whereas the other half were tapered to placebo. After 6
weeks of taking placebo or original drug, patients were tapered to
the reverse schedule and remained on it for 6 weeks. Assessments
included informant ratings by the nursing staff who completed the
Brief Psychiatric Rating Scale and the Cohen-Mansfield Agitation
Inventory. RESULTS: Analyses comparing residents taking placebo to
those taking medication after completion of the first phase showed no
impact of drug therapy discontinuation on their behavior. Similarly,
using the crossover design to compare residents' behaviors while
taking placebo vs. taking drugs, withdrawal of medication had no
impact on Cohen-Mansfield Agitation Inventory or Brief Psychiatric
Rating Scale scores. CONCLUSIONS: Results of this work suggest that
longterm use of haloperidol, thioridazine, and lorazepam in nursing
homes to manage agitation should be closely monitored for their
efficacy. Furthermore, routine attempts at drug withdrawal should be
considered for most residents taking psychotropic medication.
ARTICLE TITLE: History repeats itself (sometimes). Autopsy
Committee of the College of American Pathologists.
ARTICLE SOURCE: Arch Intern Med (United States), Sep 13 1999, 159(16)
p1837-8
AUTHOR(S): Hanzlick R; Hutchins GM
AUTHOR'S ADDRESS: Emory University School of Medicine, Atlanta, Ga,
USA.
PUBLICATION TYPE: HISTORICAL ARTICLE; JOURNAL ARTICLE
MB. It is about the value off autopsies. They have virtually stopped
in my hospital. L
ARTICLE TITLE: Use of sedation during cardioversion with the
implantable atrial defibrillator.
ARTICLE SOURCE: Circulation (United States), Oct 5 1999, 100(14)
p1499-501
AUTHOR(S): Timmermans C; Nabar A; Rodriguez LM; Ayers G; Wellens
HJ
AUTHOR'S ADDRESS: Department of Cardiology, Academic Hospital
Maastricht, Maastricht, The Netherlands.
C.Timmermans@cardio.azm.nl.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: This study suggests that, in a selected group of
patients, AF can be treated with Atrioverter therapy without
sedation. Successful ambulatory treatment of AF episodes with the
Atrioverter, programmed to deliver </=2 shocks, did not require
sedation. When multiple shocks were required to treat an AF episode,
the need for sedation increased and included patients initially not
requesting sedation.
ARTICLE TITLE: ACC/AHA guidelines for coronary artery bypass graft
surgery: executive summary and recommendations : A report of the
American College of Cardiology/American Heart Association Task Force
on Practice Guidelines (Committee to revise the 1991 guidelines for
coronary artery bypass graft surgery).
ARTICLE SOURCE: Circulation (United States), Sep 28 1999, 100(13)
p1464-80
AUTHOR(S): Eagle KA; Guyton RA; Davidoff R; Ewy GA; Fonger J; Gardner
TJ; Gott JP; Herrmann HC; Marlow RA; Nugent W; O'Connor GT; Orszulak
TA; Rieselbach RE; Winters WL; Yusuf S; Gibbons RJ; Alpert JS; Garson
A Jr; Gregoratos G; Russell RO; Ryan TJ; Smith SC Jr
PUBLICATION TYPE: JOURNAL ARTICLE
ARTICLE TITLE: Evidence for prothrombotic effects of exercise and
limited protection by aspirin.
ARTICLE SOURCE: Circulation (United States), Sep 28 1999, 100(13)
p1374-9
AUTHOR(S): Li N; Wallen NH; Hjemdahl P
AUTHOR'S ADDRESS: Department of Laboratory Medicine, Division of
Clinical Pharmacology, Karolinska Hospital, Stockholm, Sweden.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE
CONCLUSIONS: Exercise induced platelet and leukocyte activation and
platelet-leukocyte aggregation in vivo, and it increased platelet and
leukocyte responsiveness to in vitro stimulation. Aspirin treatment
attenuated certain signs of platelet activity in vivo at rest and
fMLP-induced neutrophil activation in vitro, but it did not attenuate
the prothrombotic effects of exercise.
ARTICLE TITLE: Mechanisms and models in heart failure: A
combinatorial approach.
ARTICLE SOURCE: Circulation (United States), Aug 31 1999, 100(9)
p999-1008
AUTHOR(S): Mann DL
AUTHOR'S ADDRESS: Winters Center for Heart Failure Research,
Department of Medicine, Baylor College of Medicine, and Houston
Veterans Administration Medical Center, Houston, TX 77030, USA.
dmann@bcm.tmc.edu.
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (78 references); REVIEW,
TUTORIAL
ARTICLE TITLE: Moderate alcohol consumption and the risk of sudden
cardiac death among US male physicians.
ARTICLE SOURCE: Circulation (United States), Aug 31 1999, 100(9)
p944-50
AUTHOR(S): Albert CM; Manson JE; Cook NR; Ajani UA; Gaziano JM;
Hennekens CH
AUTHOR'S ADDRESS: Division of Preventive Medicine, Department of
Medicine, Brigham and Women's Hospital, Boston, MA 02215-1204, USA.
cmalbert@bics.bwh.harvard.edu.
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: BACKGROUND: Individuals who consume high amounts of alcohol
(>5 drinks/d) have increased risks of ventricular arrhythmia and
sudden cardiac death (SCD). However, the relationship is less clear
for drinkers of light-to-moderate amounts. METHODS AND RESULTS: We
prospectively assessed whether light-to-moderate alcohol drinkers
have a decreased risk of SCD among 21 537 male participants in the
Physicians Health Study who were free of self-reported cardiovascular
disease and provided complete information on alcohol intake at study
entry. Over 12 years of follow-up, 141 SCDs were confirmed. After
control for multiple confounders, men who consumed 2 to 4 drinks/wk
(RR=0.40; 95% CI, 0.22 to 0.75; P=0.004) or 5 to 6 drinks/wk
(RR=0.21; 95% CI, 0.08 to 0.56; P=0.002) at baseline had
significantly reduced risks of SCD compared with those who rarely or
never consumed alcohol. The relationship for SCD was U-shaped (P=0.
002), with the risk approaching unity at >/=2 drinks/d. In
contrast, the relationship of alcohol intake and nonsudden CHD death
was L-shaped or linear (P for trend=0.02). CONCLUSIONS: In these
prospective data, men who consumed light-to-moderate amounts of
alcohol (2 to 6 drinks/wk) had a significantly reduced risk of SCD
compared with those who rarely or never consumed alcohol.
ARTICLE TITLE: 1999 update: ACC/AHA Guidelines for the Management
of Patients With Acute Myocardial Infarction: Executive Summary and
Recommendations: A report of the American College of
Cardiology/American Heart Association Task Force on Practice
Guidelines (Committee on Management of Acute Myocardial
Infarction).
ARTICLE SOURCE: Circulation (United States), Aug 31 1999, 100(9)
p1016-30
AUTHOR(S): Ryan TJ; Antman EM; Brooks NH; Califf RM; Hillis LD;
Hiratzka LF; Rapaport E; Riegel B; Russell RO; Smith EE 3rd; Weaver
WD; Gibbons RJ; Alpert JS; Eagle KA; Gardner TJ; Garson A Jr;
Gregoratos G; Smith SC Jr
PUBLICATION TYPE: GUIDELINE; JOURNAL ARTICLE; PRACTICE GUIDELINE
ARTICLE TITLE: Physical inactivity: an easily modified risk
factor? [editorial; comment]
COMMENTS: Comment on: Circulation 1999 Jul 6; 100(1):9-13
ARTICLE SOURCE: Circulation (United States), Jul 6 1999, 100(1)
p2-4
AUTHOR(S): Snell PG; Mitchell JH
PUBLICATION TYPE: COMMENT; EDITORIAL
ARTICLE TITLE: Women's role and satisfaction in the decision to
have a caesarean section [see comments]
COMMENTS: Comment in: Med J Aust 1999 Jun 21; 170(12):572-3
ARTICLE SOURCE: Med J Aust (Australia), Jun 21 1999, 170(12)
p580-3
AUTHOR(S): Turnbull DA; Wilkinson C; Yaser A; Carty V; Svigos JM;
Robinson JS
AUTHOR'S ADDRESS: Department of General Practice, University of
Adelaide, SA. dturnbull@medicine.adelaide.edu.au.
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: OBJECTIVE: To examine women's role in the decision to
perform caesarean section (CS). DESIGN: Cross-sectional survey.
Written questionnaires were completed seven weeks after giving birth
by CS. SETTING: An obstetric tertiary referral hospital (Women's and
Children's Hospital, Adelaide, South Australia), July to December
1996. PARTICIPANTS: A consecutive sample of women who underwent CS
over a six-month period. To be eligible, women had to be at least 18
years old, able to complete a questionnaire in English and well
enough to consent to study participation. MAIN OUTCOME MEASURES:
Women's involvement in decision making, stated preference for CS, and
satisfaction with obstetric care. RESULTS: 278 women (76.4%) returned
questionnaires: 171 women (61.5%; 95% confidence interval
[CI], 55.8%-67.2%) reported being involved in the decision to
have a CS. Factors influencing their decision were physical duress
and partner's reaction during labour (emergency CS), considerations
about recovery, planning for the event and pain (elective CS), and
information from the doctor (both groups). Half the women "strongly
agreed" that they were satisfied with the decision to have a CS, but
40.9% only "agreed" and 4.7% were "not sure". About 20% reported they
needed more information on other options, and only 28.8% "strongly
agreed" that they had been given good information to prepare for the
possibility of CS. 27.9% of women (95% CI, 22.5%-33.2%) "agreed" or
"strongly agreed" that they had "insisted on a CS" and 21.3% (95% CI,
16.4%-26.2%) that they had told the staff they were "keen to have a
CS". Given the option of a vaginal delivery, 37.8% of women (95% CI,
22.5%-55.2%) with a breech presentation, and 34% of women (95% CI,
21.2%-48.8%) who had had a previous CS, chose a CS. CONCLUSIONS: It
is of concern that over a third of women felt they had not been
involved in the decision to have a CS; others were very positive
about CS, but an appreciable proportion may not have received
sufficient information. A broad-based strategy of providing more
information to women and their partners could be one way of ensuring
appropriate CS rates and should be tested in a randomised controlled
trial.
MB. How can there be an ‘appropriate’ CS rate?
ARTICLE TITLE: Caesarean section: a matter of choice?
[editorial; comment]
COMMENTS: Comment on: Med J Aust 1999 Jun 21; 170(12):580-3
ARTICLE SOURCE: Med J Aust (Australia), Jun 21 1999, 170(12)
p572-3
AUTHOR(S): de Costa CM
PUBLICATION TYPE: COMMENT; EDITORIAL
ARTICLE TITLE: Recognising and preventing serious in-hospital
events [editorial; comment]
COMMENTS: Comment on: Med J Aust 1999 Jul 5; 171(1):22-5
ARTICLE SOURCE: Med J Aust (Australia), Jul 5 1999, 171(1) p8-9
AUTHOR(S): Hillman KM
PUBLICATION TYPE: COMMENT; EDITORIAL
ARTICLE TITLE: Management of cerebral aneurysms: current best
practice [editorial]
ARTICLE SOURCE: Med J Aust (Australia), Aug 2 1999, 171(3) p121-2
AUTHOR(S): Mitchell PJ; Tress BM
PUBLICATION TYPE: EDITORIAL
ARTICLE TITLE: Prostate cancer testing: behaviour, motivation and
attitudes among Western Australian men.
ARTICLE SOURCE: Med J Aust (Australia), Aug 16 1999, 171(4)
p185-8
AUTHOR(S): Slevin TJ; Donnelly N; Clarkson JP; English DR; Ward
JE
AUTHOR'S ADDRESS: Cancer Foundation of Western Australia, Perth.
terry@cancerwa.asn.au.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: Men are being tested for prostate cancer with minimal
pretest counselling or written information.
ARTICLE TITLE: Frank Macfarlane Burnet: virologist, immunologist
and Nobel Prize Winner.
ARTICLE SOURCE: Med J Aust (Australia), Sep 6 1999, 171(5)
p259-61
AUTHOR(S): Ada GL
AUTHOR'S ADDRESS: John Curtin School of Medical Research, Canberra,
ACT.
MEDLINE INDEXING DATE: 199912
ARTICLE TITLE: Little benefit from mild hypothermia therapy for
severely head injured patients with low intracranial pressure.
ARTICLE SOURCE: J Neurosurg (United States), Aug 1999, 91(2)
p185-91
AUTHOR(S): Shiozaki T; Kato A; Taneda M; Hayakata T; Hashiguchi N;
Tanaka H; Shimazu T; Sugimoto H
AUTHOR'S ADDRESS: Department of Traumatology, Osaka University
Medical School, Japan.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
ARTICLE TITLE: Assessing the effectiveness and optimal structure
of trauma systems: a consensus among experts.
ARTICLE SOURCE: J Trauma (United States), Sep 1999, 47(3 Suppl)
pS69-74
AUTHOR(S): Mann NC
AUTHOR'S ADDRESS: Department of Emergency Medicine, Oregon Health
Sciences University, School of Medicine, Portland 97201-3098, USA.
manncl@ohsu.edu.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSION: A consensus does exist among trauma system experts
regarding the effectiveness of trauma systems and the optimal
structure of trauma systems. Additional research is needed to
determine whether trauma system benefits extend to other patient
subgroups in other geographic regions. Consensus theory provides an
impressive model for assessing rater agreement by controlling for
response bias and providing a probability measure to determine
whether a true consensus exists.
ARTICLE TITLE: Massive transfusion of reconstituted whole blood is
well tolerated in pediatric burn surgery.
ARTICLE SOURCE: J Trauma (United States), Sep 1999, 47(3) p526-8
AUTHOR(S): Barret JP; Desai MH; Herndon DN
AUTHOR'S ADDRESS: Shriners Burn Hospital and The University of Texas
Medical Branch, Galveston, Texas, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSION: Massive transfusion of reconstituted whole blood in
severely burned pediatric patients is safe; it does not compromise
hemostasis nor is it associated with an increased rate of septic
episodes or pulmonary complications. A prospective randomized
clinical trial comparing its effectiveness versus packed red cells is
necessary.
ARTICLE TITLE: Use of the laryngeal mask airway in air transport
when intubation fails.
ARTICLE SOURCE: J Trauma (United States), Aug 1999, 47(2) p352-7
AUTHOR(S): Martin SE; Ochsner MG; Jarman RH; Agudelo WE; Davis FE
AUTHOR'S ADDRESS: Memorial Health University Medical Center,
Savannah, Georgia 31404, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSION: Our patient data show that when conventional methods have
failed, the LMA can be safely, rapidly, and effectively used for
temporary airway control.
ARTICLE TITLE: Awake aortic aneurysm repair in patients with
severe pulmonary disease.
ARTICLE SOURCE: Am J Surg (United States), Aug 1999, 178(2)
p121-4
AUTHOR(S): McGregor WE; Koler AJ; Labat GC; Perni V; Hirko MK; Rubin
JR
AUTHOR'S ADDRESS: Department of Surgery, Northside Medical
Center/Forum Health, Northeastern Ohio Universities College of
Medicine, Youngstown 44501, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: BACKGROUND: We report the use of retroperitoneal aortic
aneurysm repair utilizing exclusive regional anesthesia (no
intubation or inhalation anesthetic) in high pulmonary risk patients.
METHODS: Six patients were retrospectively reviewed. Pulmonary
disease was diagnosed by clinical history and pulmonary function
tests. Patients received intravenous sedation and regional
anesthesia. Retroperitoneal aortoiliac aneurysm repair was performed.
RESULTS: All patients used inhaled steroids and albuterol. Three
required theophylline and home oxygen. FEV1 = 23% +/- 5% predicted,
FVC = 34% +/- 5% predicted, and PO2 = 62 +/- 2 mm Hg. Operative time
was 247 +/- 25 minutes. Blood loss was 840 +/- 479 mL. Five of six
patients (83%) tolerated awake aneurysm repair and had intensive care
unit stays of 2.4 +/- 0.6 days, and postoperative hospital stays of
8.2 +/- 1.8 days. One patient was converted to general anesthesia and
had a prolonged hospital stay. CONCLUSIONS: With thorough patient
communication, awake retroperitoneal aortic aneurysm repair can be
safely performed in select patients with severe pulmonary
disease.
MB. I suppose that you can do anything if you try hard enough.
ARTICLE TITLE: Alternatives to mandated organ donation
[editorial]
ARTICLE SOURCE: Am J Surg (United States), Jun 1999, 177(6)
p443-4
AUTHOR(S): Garrison RN; Lucas BE; O'Flynn PE
PUBLICATION TYPE: EDITORIAL
ARTICLE TITLE: Erectile dysfunction in the aging man.
ARTICLE SOURCE: Med Clin North Am (United States), Sep 1999, 83(5)
p1267-78
AUTHOR(S): Kaiser FE
AUTHOR'S ADDRESS: Department of Medicine, St. Louis University School
of Medicine, Missouri, USA.
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (43 references); REVIEW,
TUTORIAL
ABSTRACT: There has been and continues to be a revolution in the
treatment available for erectile dysfunction, a disorder that affects
quality of life and sense of self-esteem. It should be considered
mandatory to assess and discuss this problem in all older men.
ARTICLE TITLE: Prevention and empiric treatment of traveler's
diarrhea.
ARTICLE SOURCE: Med Clin North Am (United States), Jul 1999, 83(4)
p945-73, vi
AUTHOR(S): Ansdell VE; Ericsson CD
AUTHOR'S ADDRESS: Department of Tropical and Travel Medicine, Kaiser
Permanente, Honolulu, Hawaii, USA.
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (102 references); REVIEW,
TUTORIAL
ABSTRACT: Diarrheal illness has plagued travelers for centuries, and
to this day it remains the most common medical problem affecting
travelers from industrialized nations to areas of the world where
substandard hygiene conditions and sanitation prevail. This article
discusses the cause of diarrheal illness in travelers, as well as
epidemiology, prevention, treatment, and a general approach to
self-treatment.
ARTICLE TITLE: Is alpha-stat management still justified for deep
hypothermic circulatory arrest in adults? [letter]
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Sep 1999,
118(3) p569-70
AUTHOR(S): Miyamoto TA; Miyamoto KJ
PUBLICATION TYPE: LETTER
MB. Quite important points about. J Thorac Cardiovasc Surg1999, 117
(1) p156-163.
ARTICLE TITLE: Is cardiopulmonary bypass still the cause of
cognitive dysfunction after cardiac operations?
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Sep 1999,
118(3) p414-20; discussion 420-1
AUTHOR(S): Taggart DP; Browne SM; Halligan PW; Wade DT
AUTHOR'S ADDRESS: Oxford Heart Centre, John Radcliffe Hospital,
United Kingdom.
PUBLICATION TYPE: CLINICAL TRIAL; CLINICAL TRIAL, PHASE II; JOURNAL
ARTICLE
CONCLUSIONS: The similar pattern of early decline and late recovery
of cognitive function in patients undergoing coronary artery bypass
grafting with and without cardiopulmonary bypass suggests that
cardiopulmonary bypass is not the major cause of postoperative
cognitive impairment. This merits consideration in deciding optimal
treatment strategies in coronary revascularization.
ARTICLE TITLE: Internal jugular vein cannulation in neurosurgical
patients: a new approach.
ARTICLE SOURCE: J Neurosurg Anesthesiol (United States), Jul 1999,
11(3) p185-7
AUTHOR(S): Kaushik S; Dubey PK; Ambesh SP
AUTHOR'S ADDRESS: Department of Anesthesiology and Critical Care
Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences,
Lucknow, India.
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: A new approach to internal jugular vein (IJV) cannulation
with the head and neck placed in the neutral position is described.
The junction of the medial two thirds and lateral one third between
the angle of the mandible and symphysis menti is identified. A
vertical line is drawn from this point to join another line drawn
between the mastoid process and the medial end of the clavicle. The
junction is the puncture point. In 120 patients studied, the failure
rate was 1.66%, and there were no complications. We propose this
technique as a safe and reliable alternative in neurosurgical
patients.
MB. I tried it out by proxy via a raw intern. It worked on a renal
transplant.
ARTICLE TITLE: Effect of music on state anxiety scores in patients
undergoing fiberoptic bronchoscopy.
ARTICLE SOURCE: Chest (United States), Sep 1999, 116(3) p819-24
AUTHOR(S): Colt HG; Powers A; Shanks TG
AUTHOR'S ADDRESS: Division of Pulmonary and Critical Care Medicine,
UCSD Medical Center-Thornton Hospital, La Jolla, CA 92037-0975,
USA.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
CONCLUSION: Relaxation music administered through headphones to
patients during flexible bronchoscopy does not decrease
procedure-related state anxiety.
MB. The trouble was the type of music. It was entitled ‘Relax’
& was piano improvisations at 60 beats/minute compared to
silence.
ARTICLE TITLE: Liver transplantation: a critical care physician's
personal odyssey.
ARTICLE SOURCE: Chest (United States), Sep 1999, 116(3) p789-91
AUTHOR(S): Brandstetter RD
AUTHOR'S ADDRESS: Department of Medicine, Sound Shore Medical Center
of Westchester, New Rochelle, NY 10802, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
MB. Wow. The poor bastard. He thought about every thing that did or
could go wrong.
ARTICLE TITLE: Hypoxemia and hypercapnia during exercise and sleep
in patients with cystic fibrosis.
ARTICLE SOURCE: Chest (United States), Sep 1999, 116(3) p647-54
AUTHOR(S): Bradley S; Solin P; Wilson J; Johns D; Walters EH;
Naughton MT
AUTHOR'S ADDRESS: Department of Respiratory Medicine and Monash
University Medical School, Alfred Hospital, Melbourne, Victoria,
Australia.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSION: Patients with moderately severe CF develop hypoxemia and
hypercapnia during exercise and sleep to a greater extent than
healthy subjects with similar respiratory muscle strength and
nutritional status. Neither respiratory muscle weakness nor
malnutrition are necessary to develop hypoxemia or hypercapnia during
exercise or sleep.
ARTICLE TITLE: Is meta-analysis really meta-physics?
ARTICLE SOURCE: Chest (United States), Aug 1999, 116(2) p539-42
AUTHOR(S): Machtay M; Kaiser LR; Glatstein E
AUTHOR'S ADDRESS: Department of Radiation Oncology, Hospital of the
University of Pennsylvania, Philadelphia 19104, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
MB. A very reasonable attack on meta-analyses and in particular one
done on radiotherapy for lung Ca.
ARTICLE TITLE: Hyperlactatemia and pulmonary lactate production in
patients with fulminant hepatic failure.
ARTICLE SOURCE: Chest (United States), Aug 1999, 116(2) p471-6
AUTHOR(S): Walsh TS; McLellan S; Mackenzie SJ; Lee A
AUTHOR'S ADDRESS: Department of Anaesthetics, Royal Infirmary,
Edinburgh, Scotland.
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: STUDY OBJECTIVES: To determine whether the lungs of
patients with fulminant hepatic failure release lactate, and if so,
whether this release relates to systemic lactate concentration or
acid base status. Another objective was to examine the accuracy of
lactate flux calculations in critically ill patients. DESIGN:
Prospective observational study. SETTING: The ICU of a major teaching
hospital. PATIENTS: Twelve patients with fulminant hepatic failure;
30 other critically ill patients in whom a pulmonary artery catheter
was in place. INTERVENTIONS: None. MEASUREMENT AND RESULTS: The
precision of whole-blood lactate measurements was assessed in 30
patients with critical illnesses of variable etiology who had a wide
range of arterial lactate concentrations. The reliability of lactate
measurements decreased with increasing lactate concentration. In each
patient with liver failure, pulmonary lactate flux was calculated on
three occasions using the Fick principle. Arterial blood lactate
concentration was consistently higher than venous concentrations,
indicating lactate release by the lungs (mean difference, 0.15
mmol/L; 95% confidence interval, 0.09 to 0.21; p<0.001). Mean
pulmonary lactate production for the 12 patients was 83 mmol/h
(range, 22 to 210 mmol/h). No patient had significant acute lung
injury. Correlations were found among the arterial lactate
concentration and both the arteriovenous (AV) lactate difference
(p<0.025) and pulmonary lactate production (p<0.05), but not
with acid-base status or cardiac output. The reliability of
individual AV lactate difference calculations and pulmonary lactate
flux calculations was poor. CONCLUSION: The lungs release lactate in
patients with fulminant hepatic failure at a rate proportional to the
degree of systemic hyperlactatemia. However, the measurement errors
associated with pulmonary lactate flux calculations using the Fick
principle are large, so individual measurements should be interpreted
with caution.
MB. I often have lactate levels during liver trasnplants higher than
the levels in these patients. Most of this appears to come from the
transfused blood
ARTICLE TITLE: Effects of humidification on nasal symptoms and
compliance in sleep apnea patients using continuous positive airway
pressure.
ARTICLE SOURCE: Chest (United States), Aug 1999, 116(2) p403-8
AUTHOR(S): Massie CA; Hart RW; Peralez K; Richards GN
AUTHOR'S ADDRESS: Alexian Brothers Medical Center, Elk Grove Village,
IL, USA. CMassie@AOL.com.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
CONCLUSIONS: Compliance with CPAP is enhanced when heated
humidification is employed. This is likely due to a reduction in side
effects associated with upper airway symptoms and a more refreshed
feeling upon awakening. Compliance gains may be realized sooner if
patients are started with heated humidity at CPAP initiation.
ARTICLE TITLE: Corticosteroids in the emergency department therapy
of acute adult asthma: an evidence-based evaluation [see
comments]
COMMENTS: Comment in: Chest 1999 Aug; 116(2):273-5
ARTICLE SOURCE: Chest (United States), Aug 1999, 116(2) p285-95
AUTHOR(S): Rodrigo G; Rodrigo C
AUTHOR'S ADDRESS: Departamento de Emergencia, Hospital Central de las
FF.AA., Montevideo, Uruguay.
PUBLICATION TYPE: JOURNAL ARTICLE; META-ANALYSIS
CONCLUSIONS: This evidence-based evaluation suggests that the
administration of parenteral corticosteroids (CCSs) to the patient on
arrival at the emergency department (ED) neither improves airflow
obstruction nor reduces the need for hospitalization. Parenteral CCSs
probably require >6 to 24 h to begin to act. Comprehensible
conclusions about admission rates in the ED setting are difficult to
make. At the 3-h assessment, only high doses of inhaled CCSs (in one
study) significantly improved pulmonary function compared with
placebo. IV and oral CCSs appear to have equivalent effects, and
there is a tendency toward improvement in pulmonary function with
medium or high doses.
ARTICLE TITLE: Steroids in acute exacerbation of asthma: how do we
grade the evidence? [editorial; comment]
COMMENTS: Comment on: Chest 1999 Aug; 116(2):285-95
ARTICLE SOURCE: Chest (United States), Aug 1999, 116(2) p273-5
AUTHOR(S): Marik PE; Varon J
PUBLICATION TYPE: COMMENT; EDITORIAL
MB. I have been asking respiratory physicians for evidence that
acuter asthma is fixed by steroids since about 1970 & why they
cannot entertain the idea that the increasing mortality over that
period is not due to their therapy.
ARTICLE TITLE: Conference summary: acute lung injury.
ARTICLE SOURCE: Chest (United States), Jul 1999, 116(1 Suppl)
p119S-126S
AUTHOR(S): Matthay MA
AUTHOR'S ADDRESS: University of California, San Francisco 94143-0624,
USA. mmatt@itsa.ucsf.edu.
PUBLICATION TYPE: CONGRESSES
ARTICLE TITLE: Levels of evidence for the pharmacologic
effectiveness of prolonged methylprednisolone treatment in
unresolving ARDS.
ARTICLE SOURCE: Chest (United States), Jul 1999, 116(1 Suppl)
p116S-118S
AUTHOR(S): Meduri GU
AUTHOR'S ADDRESS: Baptist Memorial Hospitals, and Veterans Affairs
Medical Center, University of Tennessee, Memphis 38163, USA.
umeduri@utmem1.utmem.edu.
PUBLICATION TYPE: JOURNAL ARTICLE
ARTICLE TITLE: Proceedings of the 41st Annual Thomas L. Petty
Aspen Lung Conference: Acute Lung Injury.
ARTICLE SOURCE: Chest (United States), Jul 1999, 116(1 Suppl)
p1S-127S
PUBLICATION TYPE: CONGRESSES; OVERALL
ARTICLE TITLE: Ethnicity and long-term outcome after an acute
coronary event. Multicenter Myocardial Ischemia Research Group.
ARTICLE SOURCE: Am Heart J (United States), Sep 1999, 138(3 Pt 1)
p500-6
AUTHOR(S): Nakamura Y; Moss AJ; Brown MW; Kinoshita M; Kawai C
AUTHOR'S ADDRESS: First Department of Internal Medicine, Shiga
University of Medical Science, Seta, Otsu, Japan.
nakamura@belle.shiga-u.ac.jp.
PUBLICATION TYPE: JOURNAL ARTICLE; MULTICENTER STUDY
CONCLUSIONS: Blacks have an increased rate of cardiac events after
MI, and a lower socioeconomic status may contribute to the adverse
outcome in this ethnic group.
ARTICLE TITLE: Neurosurgical evacuation of intracranial hemorrhage
after thrombolytic therapy for acute myocardial infarction:
experience from the GUSTO-I trial. Global Utilization of
Streptokinase and tissue-plasminogen activator (tPA) for Occluded
Coronary Arteries.
ARTICLE SOURCE: Am Heart J (United States), Sep 1999, 138(3 Pt 1)
p493-9
AUTHOR(S): Mahaffey KW; Granger CB; Sloan MA; Green CL; Gore JM;
Weaver WD; White HD; Simoons ML; Barbash GI; Topol EJ; Califf RM
AUTHOR'S ADDRESS: Duke Clinical Research Institute, Duke University
Medical Center, Durham, NC 27715, USA.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
CONCLUSIONS: Although intracranial hemorrhage is uncommon after
thrombolysis for acute myocardial infarction, 87% of patients die or
have disabling stroke. Although not definitive, these data indicate
that neurosurgical evacuation may be associated with improved
clinical outcomes. Physicians treating such patients should consider
early neurosurgical consultation and intervention in these
patients.
ARTICLE TITLE: Beta-blocker withdrawal: the song of Orpheus
[editorial; comment]
COMMENTS: Comment on: Am Heart J 1999 Sep; 138(3 Pt 1):456-7
ARTICLE SOURCE: Am Heart J (United States), Sep 1999, 138(3 Pt 1)
p387-9
AUTHOR(S): Eichhorn EJ
PUBLICATION TYPE: COMMENT; EDITORIAL
MB. This tries to explain the mystery that blocking sympathetic
system improves the heart.
ARTICLE TITLE: How to use ACE-inhibitors, beta-blockers, and newer
therapies in AMI.
ARTICLE SOURCE: Am Heart J (United States), Aug 1999, 138(2 Pt 2)
p183-7
AUTHOR(S): Maggioni AP; Latini R
AUTHOR'S ADDRESS: ANMCO Research Center, Department of Cardiovascular
Research, Florence, Italy.
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (32 references); REVIEW,
TUTORIAL
ABSTRACT: Besides reperfusion treatment, which is the most powerful
approach to the underlying pathophysiological cause of myocardial
infarction, adjunctive therapies should be considered to reduce
clinical symptoms, and improve left ventricular function and
mortality rates. Randomized clinical trials and overviews of
adjunctive therapy with beta-blockers and angiotensin-converting
enzyme (ACE) inhibitors showed that these treatments may further
reduce mortality rates by approximately 10%. On the basis of this
evidence, guidelines suggest that (1) all patients with acute
myocardial infarction who do not have clear contraindications should
be treated within 24 hours from the onset of symptoms with
intravenous beta-blockers. If tolerated, the treatment should be
continued for at least 2 to 3 years and perhaps longer; (2) ACE
inhibitor treatment should be started during the first day after
myocardial infarction in most patients after timely and careful
observation of the patient's hemodynamic and clinical status and
after administration of routinely recommended treatments
(thrombolysis, aspirin, and beta-blockers). In the patients showing
neither clinical symptoms nor instrumental signs of left ventricular
dysfunction, ACE inhibitor treatment can be stopped at the time of
hospital discharge and ventricular function reevaluated after an
adequate period of time.
ARTICLE TITLE: Aggravated renal dysfunction during intensive
therapy for advanced chronic heart failure [see comments]
COMMENTS: Comment in: Am Heart J 1999 Aug; 138(2 Pt 1):200-2
ARTICLE SOURCE: Am Heart J (United States), Aug 1999, 138(2 Pt 1)
p285-90
AUTHOR(S): Weinfeld MS; Chertow GM; Stevenson LW
AUTHOR'S ADDRESS: Cardiovascular Division, Department of Medicine,
Brigham Women's Hospital, Boston, MA 02115, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
CONCLUSIONS: In patients undergoing intensive treatment for heart
failure, aggravated renal dysfunction (ARD) is common and clinically
significant. The relation among baseline factors, ARD, and worsened
outcome may reflect complex cardiorenal interactions. Better
understanding of the causes and prevention of ARD during heart
failure therapy may in the future lead to better outcomes.
ARTICLE TITLE: Aggravated renal dysfunction and the acute
management of advanced chronic heart failure [editorial;
comment]
COMMENTS: Comment on: Am Heart J 1999 Aug; 138(2 Pt 1):285-90
ARTICLE SOURCE: Am Heart J (United States), Aug 1999, 138(2 Pt 1)
p200-2
AUTHOR(S): Bart BA; Goldsmith SR
PUBLICATION TYPE: COMMENT; EDITORIAL
ARTICLE TITLE: Aspirin worsens exercise performance and pulmonary
gas exchange in patients with heart failure who are taking
angiotensin-converting enzyme inhibitors [see comments]
COMMENTS: Comment in: Am Heart J 1999 Aug; 138(2 Pt 1):193-7
ARTICLE SOURCE: Am Heart J (United States), Aug 1999, 138(2 Pt 1)
p254-60
AUTHOR(S): Guazzi M; Pontone G; Agostoni P
AUTHOR'S ADDRESS: Istituto di Cardiologie dellUniversita degli Studi,
Centro di Studio per le Ricerhe Cardiovascolari del Consiglio
Nazionale delle Ricerche, Fondazione "Monzine", IRCCS, Milan, Italy.
cardguaz@imiucca.csi.unimi.it.
PUBLICATION TYPE: JOURNAL ARTICLE
.CONCLUSIONS: Aspirin (325mg/day) does not affect ventilation
efficiency and peak VO(2 ) in patients with CHF not taking ACE
inhibitors, but it worsens the pulmonary diffusion for carbon
monoxide, VO(2 ), and the ventilatory response to exercise in the
presence of ACE inhibition. This may be relevant in patients with CHF
from ischemic heart disease. Whether the same may be true of smaller
aspirin doses was not investigated in this study.
MB. I am on 100mg + ACE inhibitor. I hope that is alright.
ARTICLE TITLE: The interaction of ACE inhibitors and aspirin in
heart failure: torn between two lovers [editorial;
comment]
COMMENTS: Comment on: Am Heart J 1999 Aug; 138(2 Pt 1):254-60
ARTICLE SOURCE: Am Heart J (United States), Aug 1999, 138(2 Pt 1)
p193-7
AUTHOR(S): Teerlink JR; Massie BM
PUBLICATION TYPE: COMMENT; EDITORIAL; REVIEW (33 references); REVIEW,
TUTORIAL
ARTICLE TITLE: Intermittent inotropes for advanced heart failure:
inquiring minds want to know [editorial; comment]
COMMENTS: Comment on: Am Heart J 1999 Aug; 138(2 Pt 1):241-6; Comment
on: Am Heart J 1999 Aug; 138(2 Pt 1):247-53
ARTICLE SOURCE: Am Heart J (United States), Aug 1999, 138(2 Pt 1)
p191-2
AUTHOR(S): Silver MA
PUBLICATION TYPE: COMMENT; EDITORIAL
ARTICLE TITLE: Difficult anesthetic management during
pheochromocytoma surgery.
ARTICLE SOURCE: J Clin Anesth (United States), May 1999, 11(3)
p247-50
AUTHOR(S): Shupak RC
AUTHOR'S ADDRESS: University of Arizona Integrated Residency in
Anesthesiology, Phoenix, USA.
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: The anesthetic management of two middle-aged patients
having surgical removal of large pheochromocytomas is described. The
same team of physicians was involved in the care of the patients,
including an endocrinologist, who supervised their preoperative care.
Although the preoperative care included pharmacologic adrenergic
receptor blockade and fluid administration, guidelines for surgical
readiness did not follow those recommended in our literature. Both
patients experienced severe intraoperative hypotension after complete
interruption of the tumors' venous drainage, and one patient suffered
a cardiac arrest. Explanations for the occurrence of these problems
are discussed, including factors relating to the complexity of the
disease process. However, it is conceivable that appropriate input
from the anesthesiologist during the preoperative preparation of
these patients may have ameliorated, if not prevented, the
encountered difficulties.
ARTICLE TITLE: A smaller double-lumen tube for older children
[letter]
ARTICLE SOURCE: J Clin Anesth (United States), Feb 1999, 11(1)
p79
AUTHOR(S): Fitzmaurice BG; Zuckerman K; Brodsky JB; Hammer GB
PUBLICATION TYPE: LETTER
ARTICLE TITLE: Low-dose and high-dose acetylsalicylic acid for
patients undergoing carotid endarterectomy: a randomised controlled
trial. ASA and Carotid Endarterectomy (ACE) Trial Collaborators
[see comments]
COMMENTS: Comment in: Lancet 1999 Jun 26; 353(9171):2172-3
ARTICLE SOURCE: Lancet (England), Jun 26 1999, 353(9171) p2179-84
AUTHOR(S): Taylor DW; Barnett HJ; Haynes RB; Ferguson GG; Sackett DL;
Thorpe KE; Simard D; Silver FL; Hachinski V; Clagett GP; Barnes R;
Spence JD
AUTHOR'S ADDRESS: Department of Clinical Epidemiology and
Biostatistics, McMaster University, Hamilton, Ontario, Canada.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY;
RANDOMIZED CONTROLLED TRIAL
INTERPRETATION: The risk of stroke, myocardial infarction, and death
within 30 days and 3 months of endarterectomy is lower for patients
taking 81 mg or 325 mg acetylsalicylic acid daily than for those
taking 650 mg or 1300 mg.
ARTICLE TITLE: Low doses of aspirin in stroke prevention
[comment]
COMMENTS: Comment on: Lancet 1999 Jun 26; 353(9171):2179-84
ARTICLE SOURCE: Lancet (England), Jun 26 1999, 353(9171) p2172-3
AUTHOR(S): van Gijn J
AUTHOR'S ADDRESS: Department of Neurology, University Medical Centre,
Utrecht, The Netherlands.
PUBLICATION TYPE: COMMENT; JOURNAL ARTICLE
ARTICLE TITLE: The Nobel chronicles. 1960: Sir Frank Macfarlance
Burnet (1899-1985), and Sir Peter Brian Medawar (1915-87).
ARTICLE SOURCE: Lancet (England), Jun 26 1999, 353(9171) p2253
AUTHOR(S): Raju TN
AUTHOR'S ADDRESS: University of Illinois, Chicago, USA. ]
PUBLICATION TYPE: BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE
ARTICLE TITLE: Inguinal herniorrhaphy: for surgical specialists
only? [comment]
COMMENTS: Comment on: Lancet 1999 Jul 17; 354(9174):185-90
ARTICLE SOURCE: Lancet (England), Jul 17 1999, 354(9174) p175-6
AUTHOR(S): Rattner DW
AUTHOR'S ADDRESS: Department of Surgery, Massachusetts General
Hospital, Boston 02114, USA.
PUBLICATION TYPE: COMMENT; JOURNAL ARTICLE
ARTICLE TITLE: Daily sunscreen application and betacarotene
supplementation in prevention of basal-cell and squamous-cell
carcinomas of the skin: a randomised controlled trial [see
comments]
COMMENTS: Comment in: Lancet 1999 Aug 28; 354(9180):699-700
ARTICLE SOURCE: Lancet (England), Aug 28 1999, 354(9180) p723-9
AUTHOR(S): Green A; Williams G; Neale R; Hart V; Leslie D; Parsons P;
Marks GC; Gaffney P; Battistutta D; Frost C; Lang C; Russell A
AUTHOR'S ADDRESS: Epidemiology and Population Health Unit, Queensland
Institute of Medical Research, Brisbane, University of Queensland,
Australia. adeleG@qimr.edu.au.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
INTERPRETATION: There was no harmful effect of daily use of sunscreen
in this medium-term study. Cutaneous squamous-cell carcinoma, but not
basal-cell carcinoma seems to be amenable to prevention through the
routine use of sunscreen by adults for 4.5 years. There was no
beneficial or harmful effect on the rates of either type of skin
cancer, as a result of betacarotene supplementation.
ARTICLE TITLE: Efficacy of sunscreens in protection against skin
cancer [comment]
COMMENTS: Comment on: Lancet 1999 Aug 28; 354(9180):723-9
ARTICLE SOURCE: Lancet (England), Aug 28 1999, 354(9180) p699-700
AUTHOR(S): Hill D
AUTHOR'S ADDRESS: Centre for Behavioural Research in Cancer, Cancer
Control Research Institute, Anti-Cancer Council of Victoria,
Australia.
MAJOR SUBJECT HEADING(S): Carcinoma, Squamous Cell [prevention
& control]; Neoplasms, Radiation-Induced [prevention
& control]; Skin Neoplasms [prevention &
control]; Sunscreening Agents [administration &
dosage]; Ultraviolet Rays [adverse effects]
MINOR SUBJECT HEADING(S): Adult; Carcinoma, Squamous Cell
[etiology]; Evidence-Based Medicine; Neoplasms,
Radiation-Induced [etiology]; Queensland; Skin Neoplasms
[etiology]
PUBLICATION TYPE: COMMENT; JOURNAL ARTICLE
ARTICLE TITLE: Are we really dying for a tan?
ARTICLE SOURCE: BMJ (England), Jul 10 1999, 319(7202) p114-6
AUTHOR(S): Ness AR; Frankel SJ; Gunnell DJ; Smith GD
AUTHOR'S ADDRESS: University of Bristol, Department of Social
Medicine, Bristol BS6 7DP. Andy.Ness@bris.ac.uk.
PUBLICATION TYPE: JOURNAL ARTICLE
They think that sum light might be good for you. L
ARTICLE TITLE: Lactate is an unreliable indicator of tissue
hypoxia in injury or sepsis.
ARTICLE SOURCE: Lancet (England), Aug 7 1999, 354(9177) p505-8
AUTHOR(S): James JH; Luchette FA; McCarter FD; Fischer JE
AUTHOR'S ADDRESS: Department of Surgery, University of Cincinnati
Medical Center, OH, USA. jamesjh@ucmail.uc.edu.
PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (47 references); REVIEW,
TUTORIAL
ABSTRACT: High blood lactate concentration (hyperlactacidaemia) in
trauma or sepsis is thought to indicate tissue hypoxia and anaerobic
glycolysis even when blood pressure, cardiac output, and urine output
are within clinically acceptable ranges. However, mechanisms of
lactate generation by well-oxygenated tissues have received little
attention. Within cells, oxidative and glycolytic energy production
can proceed in separate, independent compartments. In skeletal muscle
and other tissues, aerobic glycolysis is linked to ATP provision for
the Na+-K+ pump, the activity of which is stimulated by epinephrine.
In injured patients, hypokalaemia may reflect increased Na+,K+-ATPase
activity. We propose that increased blood lactate often reflects
increased aerobic glycolysis in skeletal muscle secondary to
epinephrine-stimulated Na+,K+-ATPase activity and not anaerobic
glycolysis due to hypoperfusion. The hypothesis explains why
hyperlactacidaemia often neither correlates with traditional
indicators of perfusion nor diminishes with increased oxygen
delivery. When other variables have returned to normal, continued
attempts at resuscitation based on elevated blood lactate may lead to
unnecessary use of blood transfusion and inotropic agents in an
effort to increase oxygen delivery and lactate clearance.
ARTICLE TITLE: Will elderly patients stand aside for younger
patients in the queue for cardiac services?
ARTICLE SOURCE: Lancet (England), Aug 7 1999, 354(9177) p467-70
AUTHOR(S): Mariotto A; De Leo D; Buono MD; Favaretti C; Austin P;
Naylor CD
AUTHOR'S ADDRESS: Unit for Technology Assessment and Quality
Assurance, Medical Directorate, Padova, Italy.
farmosp16@pd.nettuno.it.
PUBLICATION TYPE: JOURNAL ARTICLE
INTERPRETATION: The majority of elderly citizens were hypothetically
willing to cede priority in accessing cardiac care to younger or
self-employed persons, but this willingness was attenuated among the
"young" elderly and more privileged respondents. Non-elderly
respondents were much less self-sacrificing, suggesting that ageing
baby-boomers may be more assertive about their continuing rights to
health care.
ARTICLE TITLE: Oral corticosteroids in patients admitted to
hospital with exacerbations of chronic obstructive pulmonary disease:
a prospective randomised controlled trial [see comments]
COMMENTS: Comment in: Lancet 1999 Aug 7; 354(9177):440-1
ARTICLE SOURCE: Lancet (England), Aug 7 1999, 354(9177) p456-60
AUTHOR(S): Davies L; Angus RM; Calverley PM
AUTHOR'S ADDRESS: Aintree Chest Centre and Department of Medicine,
University Hospital Aintree, University of Liverpool, UK.
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED
CONTROLLED TRIAL
INTERPRETATION: These data provide evidence to support the current
practice of prescribing low-dose oral corticosteroids to all patients
with non-acidotic exacerbations of COPD requiring hospital
admission.
ARTICLE TITLE: Emerging role of corticosteroids in chronic
obstructive pulmonary disease [comment]
COMMENTS: Comment on: Lancet 1999 Aug 7; 354(9177):456-60
ARTICLE SOURCE: Lancet (England), Aug 7 1999, 354(9177) p440-1
AUTHOR(S): Banner AS
AUTHOR'S ADDRESS: Harvard Medical School and Veterans Affairs Medical
Center, Manchester, NH 03104-7004, USA.
PUBLICATION TYPE: COMMENT; JOURNAL ARTICLE