MB's Articles of Interest - May 2002

ARTICLE TITLE: The 24-hour blood pressure pattern: does it have implications for morbidity and mortality?
ARTICLE SOURCE: Am J Cardiol (United States), Jan 24 2002, 89(2A) p27A-33A
AUTHOR(S): Weber MA
AUTHOR'S ADDRESS: State University of New York Downstate Medical College, Brooklyn, New York, USA. michaelwebermd@cs.com.
PUBLICATION TYPEJournal Article; Meta-Analysis
MB: Advertising a proposed big trial

ARTICLE TITLE: Criminal consequences of commotio cordis.
ARTICLE SOURCE: Am J Cardiol (United States), Jan 15 2002, 89(2) p210-3
AUTHOR(S): Maron BJ; Mitten MJ; Greene Burnett C
INDEXING CHECK TAG(S): Female; Human; Male; Support, Non-U.S. Gov't
PUBLICATION TYPE: Editorial; Review; Review, Multicase
MB: Sudden death after blunt chest trauma usually in rough sport.

ARTICLE TITLE: Comparison of perindopril versus captopril for treatment of acute myocardial infarction.
ARTICLE SOURCE: Am J Cardiol (United States), Jan 15 2002, 89(2) p150-4
AUTHOR(S): Lau CP; Tse HF; Ng W; Chan KK; Li SK; Keung KK; Lau YK; Chen WH; Tang YW; Leung SK
AUTHOR'S ADDRESS: Queen Mary Hospital, Hong Kong, China. cplau@hkucc.hku.hk.
PUBLICATION TYPEClinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
At initial administration, target doses of perindopril and captopril were attained in 97% and 82% of the patients, respectively (p < 0.01). After 6 months, there were no differences between patients treated with perindopril and captopril in mortality rates (6% vs 13%, p = 0.16) and need for revascularization (20% vs 21%, p = 0.9). Thus, in patients during with acute myocardial infarction (AMI), perindopril treatment showed better short-term tolerance than treatment with captopril, with significantly less acute hemodynamic changes and fewer withdrawals.

ARTICLE TITLE: Risk factors for acute myocardial infarction in the elderly (the Dubbo study).
ARTICLE SOURCE: Am J Cardiol (United States), Jan 1 2002, 89(1) p69-72
AUTHOR(S): Simons LA; Simons J; Friedlander Y; McCallum J
AUTHOR'S ADDRESS: University of New South Wales Lipid Research Department, St Vincent's Hospital, Sydney, Australia. l.simons@notes.med.unsw.edu.au.
PUBLICATION TYPE: Journal Article
MB: A long term study started in 1988 in Dubbo 2830, NSW.oz.

ARTICLE TITLE: Effect of spaceflight on cardiovascular responses to upright posture in a 77-year-old astronaut.
ARTICLE SOURCE: Am J Cardiol (United States), Dec 1 2001, 88(11) p1335-7
AUTHOR(S): Rossum AC; Ziegler MG; Meck JV
AUTHOR'S ADDRESS: Phoenix Heart, Glendale, Arizona, USA.
PUBLICATION TYPE: Journal Article
MB: He was 'fit' so not much happened but it was more like an old person than a young one.

ARTICLE TITLE: Effect of beta blockers alone, of angiotensin-converting enzyme inhibitors alone, and of beta blockers plus angiotensin-converting enzyme inhibitors on new coronary events and on congestive heart failure in older persons with healed myocardial infarcts and asymptomatic left ventricular systolic dysfunction.
ARTICLE SOURCE: Am J Cardiol (United States), Dec 1 2001, 88(11) p1298-300
AUTHOR(S): Aronow WS; Ahn C; Kronzon I
AUTHOR'S ADDRESS: Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, New York 10804, USA. WSAronow@aol.com.
PUBLICATION TYPE: Journal Article
MB: Combined treatment is best. That's what I'm on.

ARTICLE TITLE: The performance of master surgeons on standard aptitude testing.
ARTICLE SOURCE: Am J Surg (United States), Jul 2001, 182(1) p30-3
AUTHOR(S): Francis NK; Hanna GB; Cresswell AB; Carter FJ; Cuschieri A
AUTHOR'S ADDRESS: Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, University of Dundee, DD1 9SY, Scotland, Dundee, United Kingdom.
PUBLICATION TYPEClinical Trial; Controlled Clinical Trial; Journal Article
CONCLUSION: The level of eye-hand coordination and manual dexterity of master surgeons was found to be higher than that of the average norm including medical students, while their visuo-spatial ability was lower.

ARTICLE TITLE: Can we improve trauma mortality in a state with a voluntary trauma system
ARTICLE SOURCE: Am J Surg (United States), Dec 2001, 182(6) p738-42
AUTHOR(S): Brink JA; Allen CF; Goslar PW; Barry MA
AUTHOR'S ADDRESS: Department of Surgery (Trauma Service), Good Samaritan Regional Medical Center and University of Arizona College of Medicine (Phoenix Campus), 925 E. McDowell, 85006, Phoenix, AZ, USA.
PUBLICATION TYPE: Journal Article
Conclusion: The data suggest that patients are arriving at the appropriate facility for definitive care despite the absence of a formal statewide trauma system.

ARTICLE TITLE: Postoperative atrial fibrillation in noncardiothoracic surgical patients
ARTICLE SOURCE: Am J Surg (United States), Dec 2001, 182(6) p713-5
AUTHOR(S): Christians KK; Wu B; Quebbeman EJ; Brasel KJ
AUTHOR'S ADDRESS: Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., 53226, Milwaukee, WI, USA.
PUBLICATION TYPE: Journal Article
Conclusions: New onset atrial fibrillation in this group of noncardiothoracic surgical patients is an uncommon problem that is a morbid event associated with significant mortality.

ARTICLE TITLE: Prophylactic antibiotics are not indicated in clean general surgery cases
ARTICLE SOURCE: Am J Surg (United States), Dec 2001, 182(6) p682-6
AUTHOR(S): Knight R; Charbonneau P; Ratzer E; Zeren F; Haun W; Clark J
AUTHOR'S ADDRESS: Department of Surgery Education, Exempla Saint Joseph Hospital, 1835 Franklin St., 80218-1191, Denver, CO, USA.
PUBLICATION TYPE: Journal Article
Conclusions: No statistically significant decrease in infection rate was demonstrated by us using prophylactic antibiotics, regardless of the National Nosocomial Infection Surveillance (NNIS)classification in clean general surgery cases.

ARTICLE TITLE: Can we do better with postoperative pain management?
ARTICLE SOURCE: Am J Surg (United States), Nov 2001, 182(5) p440-8
AUTHOR(S): Huang N; Cunningham F; Laurito CE; Chen C
AUTHOR'S ADDRESS: University of Illinois College of Pharmacy, M/C 886, 833 S. Wood St., Rm. 164, Chicago, IL 60612-7230, USA.
PUBLICATION TYPE: Journal Article; Meta-Analysis
METHODS: Literature was retrieved by searches from 1996 to 2000 Medline and CINAHL (nursing database), using keywords "postoperative pain," "postsurgical pain," "patient outcomes," "pain outcomes," "survey," "questionnaire," and "practice guidelines." RESULTS: Overall, current practice standards have had minimal impact on decreasing patients' reports of pain. The incidence of moderate to severe pain with cardiac, abdominal, and orthopedic inpatient procedures has been reported as high as 25% to 50%, and incidence of moderate pain after ambulatory procedures is 25% or higher. CONCLUSIONS: Despite the advances, the incidence of pain remains high. Yet the future is promising, with new standards from the Joint Commission on Accreditation of Health care Organizations paving the way for reduction of institutional barriers and improved implementation of guidelines.
MB: I can't see any evidence of the promise. It is pretty obvious it's not going to work. Why do we persist with the ideology.

ARTICLE TITLE: Thoracic epidural versus patient-controlled analgesia in elective bowel resections
ARTICLE SOURCE: Am J Surg (United States), Dec 2001, 182(6) p570-7
AUTHOR(S): Paulsen EK; Porter MG; Helmer SD; Linhardt PW; Kliewer ML
AUTHOR'S ADDRESS: Department of Surgery, University of Kansas School of Medicine-Wichita, 929 North St. Francis, 67214, Wichita, KS, USA.
PUBLICATION TYPE: Journal Article
Conclusions: Although pain scores were significantly lower in the epidural group, this did not translate into a quicker return of bowel function or earlier discharge of the patient. Furthermore, the epidural group had a significantly higher complication rate and cost. Therefore, while thoracic epidural analgesia provides superior pain control, it does not offer a significant advantage over patient-controlled analgesia in return of bowel function after bowel resection.
MB: Another equivocal 'study'.

ARTICLE TITLE: Two for the price of one--is it worth it?
ARTICLE SOURCE: Anaesthesia (England), Jan 2002, 57(1) p1-3
AUTHOR(S): Charlton JE
PUBLICATION TYPE: Editorial
MB: No money for pain services in the UK NHS.

ARTICLE TITLE: Comparison of continuous epidural infusion of ropivacaine and sufentanil with intravenous patient-controlled analgesia after total hip replacement.
ARTICLE SOURCE: Anaesthesia (England), Dec 2001, 56(12) p1189-93
AUTHOR(S): Kampe S; Randebrock G; Kiencke P; Hunseler U; Cranfield K; Konig DP; Diefenbach C
AUTHOR'S ADDRESS: Department of Anaesthesia and Intensive Care Medicine, University of Cologne, Joseph-Stelzmann-Str. 9, 50931, Cologne, Germany. sandra.kampe@t-online.de.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
We conclude that the epidural infusion of ropivacaine 0.1% and sufentanil 1 microg x ml(-1) is superior to intravenous opioid by patient-controlled analgesia in preventing pain after total hip replacement, with fewer adverse effects and greater patient satisfaction.
MB: Not many patients (12 & 11). Only assessed them at 4 hours post-operative.

ARTICLE TITLE: One visual analogue pain score is sufficient after laparoscopic cholecystectomy
ARTICLE SOURCE: Br J Surg (England), Jan 2002, 89(1) p114-5
AUTHOR(S): Schwenk W; Mall JW; Neudecker J; Muller JM
AUTHOR'S ADDRESS: Department of General, Visceral, Vascular and Thoracic Surgery, Medical Faculty of Humboldt University at Berlin, Charite, Campus Mitte, Schumannstrasse 20/21, 10117 Berlin, Germany.
PUBLICATION TYPE: Journal Article
MB: They are only surgeons. They looked at VAS sitting compared to coughing.

ARTICLE TITLE: Mortality associated with anaesthesia: a qualitative analysis to identify risk factors.
ARTICLE SOURCE: Anaesthesia (England), Dec 2001, 56(12) p1141-53
AUTHOR(S): Arbous MS; Grobbee DE; van Kleef JW; de Lange JJ; Spoormans HH; Touw P; Werner FM; Meursing AE
AUTHOR'S ADDRESS: Department of Anaesthesia, Leiden University Medical Center, Leiden, The Netherlands.
PUBLICATION TYPE: Journal Article; Multicenter Study
ABSTRACT: From a prospectively defined cohort of patients who underwent either general, regional or combined anaesthesia from 1 January 1995 to 1 January 1997 (n = 869 483), all consecutive patients (n = 811) who died within 24 h or remained unintentionally comatose 24 h after anaesthesia were classified to determine a relationship with anaesthesia. These deaths (n = 119; 15%) were further analysed to identify contributing aspects of the anaesthetic management, other factors and the appropriateness of care. The incidence of 24-h peri-operative death per 10 000 anaesthetics was 8.8 (95% CI 8.2-9.5), of peri-operative coma was 0.5 (0.3-0.6) and of anaesthesia-related death 1.4 (1.1-1.6). Of the 119 anaesthesia-related deaths, 62 (52%) were associated with cardiovascular management, 57 (48%) with other anaesthetic management, 12 (10%) with ventilatory management and 12 (10%) with patient monitoring. Inadequate preparation of the patient contributed to 30 (25%) of the anaesthesia-related deaths. During induction of anaesthesia, choice of anaesthetic technique (n = 18 (15%)) and performance of the anaesthesiologist (n = 8 (7%)) were most commonly associated with death. During maintenance, the most common factors were cardiovascular management (n = 43 (36%)), ventilatory management (n = 12 (10%)) and patient monitoring (n = 12 (10%)). In both the recovery and the postoperative phases, patient monitoring was the most common factor (n = 12 (10%) for both). For cardiovascular, ventilatory and other anaesthetic management, human failure contributed to 89 (75%) deaths and organisational factors to 12 (10%). For inadequate patient monitoring, human factors contributed to 71 (60%) deaths and organisational factors to 48 (40%). Other contributing factors were inadequate communication (30 deaths (25%) for all four aspects of the anaesthetic management) and lack of supervision (particularly for ventilatory management). Inadequate care was delivered in 19 (16%) of the anaesthesia-related deaths with respect to cardiovascular management, in 20 (17%) with respect to ventilatory management, in 18 (15%) with respect to patient monitoring and in 23 (19%) with respect to other anaesthetic management.

ARTICLE TITLE: Activated protein C: the cure for sepsis - again?
ARTICLE SOURCE: Anaesthesia (England), Dec 2001, 56(12) p1133-5
AUTHOR(S): Hoth T; Evans TW
PUBLICATION TYPE: Editorial
MB: Seems to improve mortality.

ARTICLE TITLE: Evaluation of diagonal earlobe crease as a marker of coronary artery disease: the use of this sign in pre-operative assessment.
ARTICLE SOURCE: Anaesthesia (England), Dec 2001, 56(12) p1160-2
AUTHOR(S): Kuri M; Hayashi Y; Kagawa K; Takada K; Kamibayashi T; Mashimo T
AUTHOR'S ADDRESS: Department of Anaesthesiology, Osaka University Faculty of Medicine (D-7), 2-2, Yamada-oka, Suita Osaka, 565-0871, Japan.
PUBLICATION TYPE: Evaluation Studies; Journal Article
The data suggest that the earlobe crease sign may be a useful marker for the presence of coronary artery disease in patients undergoing emergency operations in which little or no history and investigations are available. However, more work is required to assess the use of this sign in other ethnic groups.
MB: There are 7 other similar reports. It does not occur only in Japan.

ARTICLE TITLE: Effect of chronic renal failure on mortality rate following arterial reconstruction
ARTICLE SOURCE: Br J Surg (England), Jan 2002, 89(1) p70-3
AUTHOR(S): Gerrard DJ; Ray SA; Barrio EA; Wood CH; Scoble JE; Taylor PR
AUTHOR'S ADDRESS: Department of Surgery, Guy's and St Thomas' Hospital, London SE1 7EH, UK.
PUBLICATION TYPE: Status: In-Process
Journal Article
CONCLUSION: Patients with chronic renal failure undergoing arterial surgery have a poor outcome compared with those with normal renal function.

ARTICLE TITLE: Drug company fined 2.2 million pounds for abusing its dominant position.
ARTICLE SOURCE: BMJ (England), Jan 26 2002, 324(7331) p188
AUTHOR(S): Dyer C
PUBLICATION TYPE: News
MB: They gave 90% discounts to hospitals expecting that the GPs would continue the same drug but at the full price.

ARTICLE TITLE: "We all have AIDS": case for reducing the cost of HIV drugs to zero.
COMMENTS: Comment In: Comment In: RefSource:BMJ. 2002 Jan 26; 324(7331):216-7; Comment In: Comment In: RefSource:BMJ. 2002 Jan 26; 324(7331):217-8
ARTICLE SOURCE: BMJ (England), Jan 26 2002, 324(7331) p214-6
AUTHOR(S): Berwick D
AUTHOR'S ADDRESS: Institute for Healthcare Improvement, 375 Longwood Avenue, Boston, MA 02215, USA. dberwick@ihi.org.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial.
MB: We are all under threat so we should all defend the present victims. They liken it to the King of Denmark wearing the Star of David.

ARTICLE TITLE: UK league table reveals variations in mortality rate after heart surgery.
ARTICLE SOURCE: Lancet (England), Nov 24 2001, 358(9295) p1790
AUTHOR(S): Frankish H
PUBLICATION TYPE: News

ARTICLE TITLE: Performance of individual surgeons to be published.
ARTICLE SOURCE: BMJ (England), Jan 26 2002, 324(7331) p189
AUTHOR(S): Vass A
PUBLICATION TYPE: News
They are starting with CABGs

ARTICLE TITLE: Cardiac surgeons in England face publication of outcomes data.
ARTICLE SOURCE: Lancet (England), Jan 26 2002, 359(9303) p329
AUTHOR(S): Ramsay S
PUBLICATION TYPE: News
MB: I hope they can even everything up.

ARTICLE TITLE: Getting more for their dollar: a comparison of the NHS with California's Kaiser Permanente.
COMMENTS: Comment In: Comment In: RefSource:BMJ. 2002 Jan 19; 324(7330):127-8; Comment In: Comment In: RefSource:BMJ. 2002 Jan 19; 324; Comment In: Comment In: RefSource:BMJ. 2002 Jan 19; 324(7330):142-3; Comment In: Comment In: RefSource:BMJ. 2002 Jan 19; 324
ARTICLE SOURCE: BMJ (England), Jan 19 2002, 324(7330) p135-41
AUTHOR(S): Feachem RG; Sekhri NK; White KL
AUTHOR'S ADDRESS: Institute for Global Health, University of California, San Francisco, 94105, USA. rfeachem@psg.ucsf.edu.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The widely held beliefs that the NHS is efficient and that poor performance in certain areas is largely explained by under investment are not supported by this analysis. Kaiser achieved better performance at roughly the same cost as the NHS because of integration throughout the system, efficient management of hospital use, the benefits of competition, and greater investment in information technology.

ARTICLE TITLE: Oh NHS, thou art sick. The NHS' main problem may be overpoliticisation.
COMMENTS: Comment On: Comment On: RefSource:BMJ. 2002 Jan 19; 324
ARTICLE SOURCE: BMJ (England), Jan 19 2002, 324(7330) p127-8
AUTHOR(S): Smith R
PUBLICATION TYPEComment; Editorial
MB: About the preceding article. They are getting desparate.

ARTICLE TITLE: Urgent reform of NHS governance needed
ARTICLE SOURCE: BMJ (England), Feb 23 2002, 324(7335) p446
AUTHOR(S): White C
PUBLICATION TYPE: News

ARTICLE TITLE: The "redisorganisation" of the NHS.
ARTICLE SOURCE: BMJ (England), Dec 1 2001, 323(7324) p1262-3
AUTHOR(S): Smith J; Walshe K; Hunter DJ
PUBLICATION TYPE: Editorial
MB: Despair.

ARTICLE TITLE: Surgeon cleared of manslaughter.
ARTICLE SOURCE: BMJ (England), Jan 5 2002, 324(7328) p8
AUTHOR(S): Dyer C
PUBLICATION TYPE: News
MB: Heart perforation putting in a Hickman's catheter.

ARTICLE TITLE: Informed consent: lessons from Australia.
ARTICLE SOURCE: BMJ (England), Jan 5 2002, 324(7328) p39-41
AUTHOR(S): Skene L; Smallwood R
AUTHOR'S ADDRESS: Faculty of Law, University of Melbourne, Parkville, Victoria 3010, Australia. l.skene@unimelb.edu.au.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Comparing percutaneous tracheostomy with open surgical tracheostomy.
ARTICLE SOURCE: BMJ (England), Jan 5 2002, 324(7328) p3-4
AUTHOR(S): Susanto I
PUBLICATION TYPE: Editorial

ARTICLE TITLE: United States starts to consider paying organ donors
ARTICLE SOURCE: BMJ (England), Feb 23 2002, 324(7335) p446
AUTHOR(S): Josefson D
PUBLICATION TYPE: News

ARTICLE TITLE: Postoperative starvation after gastrointestinal surgery
ARTICLE SOURCE: BMJ (England), Feb 23 2002, 324(7335) p481
AUTHOR(S): Bozzetti F; Mariani L; Goodfellow PB; Everitt NJ; Lewis SJ; Egger M; Sylvester PA; Thomas S; Fawcett WJ; Jewsbury WE; Moynagh P
AUTHOR'S ADDRESS: mariani@istitutotumori.mi.it Department of Surgery and Biometric Unit, National Cancer Institute, 1 20133 Milan, Italy.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: US panel finds insufficient evidence to support mammography
ARTICLE SOURCE: BMJ (England), Feb 2 2002, 324(7332) p255
AUTHOR(S): Charatan F
AUTHOR'S ADDRESS: Florida.
PUBLICATION TYPE: Journal Article
MB: This is becoming exciting. There is a big industry involved.

ARTICLE TITLE: "Unwarranted survivals" and "anomalous deaths" from coronary heart disease: prospective survey of general population.
ARTICLE SOURCE: BMJ (England), Dec 22-29 2001, 323(7327) p1487-91
AUTHOR(S): McConnachie A; Hunt K; Emslie C; Hart C; Watt G
AUTHOR'S ADDRESS: Department of General Practice, University of Glasgow, Glasgow G12 0RR, UK.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Differences in survival between these extreme risk groups are dramatic. Health promotion messages would be more credible if they discussed anomalies and the limits of prediction of coronary disease at an individual level.

ARTICLE TITLE: Christiaan Barnard: his first transplants and their impact on concepts of death.
ARTICLE SOURCE: BMJ (England), Dec 22-29 2001, 323(7327) p1478-80
AUTHOR(S): Hoffenberg R
PUBLICATION TYPE: Biography; Historical Article; Journal Article

ARTICLE TITLE: Effects of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: randomised controlled trial.
ARTICLE SOURCE: BMJ (England), Dec 22-29 2001, 323(7327) p1450-1
AUTHOR(S): Leibovici L
AUTHOR'S ADDRESS: Department of Medicine, Beilinson Campus, Rabin Medical Center, Petah-Tiqva 49100, Israel. leibovic@post.tau.ac.il.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
ABSTRACT: OBJECTIVE: To determine whether remote, retroactive intercessory prayer, said for a group of patients with a bloodstream infection, has an effect on outcomes. DESIGN: Double blind, parallel group, randomised controlled trial of a retroactive intervention. CONCLUSION: Remote, retroactive intercessory prayer said for a group is associated with a shorter stay in hospital and shorter duration of fever in patients with a bloodstream infection and should be considered for use in clinical practice.
MB: This is not the first such study.

ARTICLE TITLE: Prescriptions for antiulcer drugs in Australia: volume, trends, and costs.
ARTICLE SOURCE: BMJ (England), Dec 8 2001, 323(7325) p1338-9
AUTHOR(S): Westbrook JI; Duggan AE; McIntosh JH
AUTHOR'S ADDRESS: Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, 2305, NSW, Australia. J.Westbrook@unsw.edu.au.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Epidemiology of asthma: severity matters.
COMMENTS: Comment On: Comment On: RefSource:Chest. 2002 Jan; 121(1):135-42/PMID:11796442
ARTICLE SOURCE: Chest (United States), Jan 2002, 121(1) p6-8
AUTHOR(S): Weissman DN
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Severe accidental hypothermia treated in an ICU: prognosis and outcome.
ARTICLE SOURCE: Chest (United States), Dec 2001, 120(6) p1998-2003
AUTHOR(S): Vassal T; Benoit-Gonin B; Carrat F; Guidet B; Maury E; Offenstadt G
AUTHOR'S ADDRESS: Service des Urgences, Hopital Saint-Antoine, Assistance Publique - Hopitaux de Paris (AP-HP), Paris, France.
PUBLICATION TYPE: Journal Article
ABSTRACT: (Cut) STUDY OBJECTIVES: To assess the characteristics and outcomes of patients admitted to an ICU for severe accidental hypothermia, and to identify risk factors for mortality. METHODS: All consecutive patients admitted to an ICU between January 1, 1979, and July 31, 1998, with a temperature of < or = 32 degrees C were retrospectively analyzed. Rewarming was always conducted passively with survival blankets and conventional covers. Patient characteristics at ICU admission were as follows: temperature, 28.8 +/- 2.5 degrees C; systolic BP, 85 +/- 23 mm Hg; heart rate, 60 +/- 24 beats/min; Glasgow Coma Scale, 10.4 +/- 3.7; and simplified acute physiology score (SAPS) II, 50.9 +/- 27. Mechanical ventilation was necessary in 23 cases, and 22 patients in shock received vasoactive drugs. The mean length of stay in the ICU was 6.7 +/- 9 days. Eighteen patients (38%) died, but ventricular arrhythmia was never the cause. It remains to be determined whether aggressive rather than passive rewarming procedures are better.

ARTICLE TITLE: Swan-Ganz catheter-induced pulmonary artery pseudoaneurysm formation: three case reports and a review of the literature.
ARTICLE SOURCE: Chest (United States), Dec 2001, 120(6) p2105-11
AUTHOR(S): Poplausky MR; Rozenblit G; Rundback JH; Crea G; Maddineni S; Leonardo R
AUTHOR'S ADDRESS: Department of Radiology, New York Medical College, Westchester Medical Center, Valhalla, NY 10595, USA. Poplauskym@wcmc.com.
PUBLICATION TYPE: Journal Article
MB: I had one. The police came.

ARTICLE TITLE: Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine.
ARTICLE SOURCE: Chest (United States), Dec 2001, 120(6 Suppl) p375S-95S
AUTHOR(S): MacIntyre NR; Cook DJ; Ely EW; Epstein SK; Fink JB; Heffner JE; Hess D; Hubmayer RD; Scheinhorn DJ
AUTHOR'S ADDRESS: Duke University Medical Center, Box 3911, Durham, NC 27710, USA. neil.macintyre@duke.edu; Collective Name: American College of Chest Physicians; Collective Name: American Association for Respiratory Care; Collective Name: American College of Critical Care Medicine.
PUBLICATION TYPE: Consensus Development Conference; Guideline; Journal Article; Practice Guideline; Review

ARTICLE TITLE: Trials comparing alternative weaning modes and discontinuation assessments.
ARTICLE SOURCE: Chest (United States), Dec 2001, 120(6 Suppl) p425S-37S
AUTHOR(S): Meade M; Guyatt G; Sinuff T; Griffith L; Hand L; Toprani G; Cook DJ
AUTHOR'S ADDRESS: Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
PUBLICATION TYPE: Journal Article; Meta-Analysis
ABSTRACT: We identified 16 randomized controlled trials (RCTs) of methods for weaning patients from mechanical ventilation. <snip> Nevertheless, the results of these studies suggest the possibility that multiple daily T-piece weaning or pressure support may be superior to synchronized intermittent mandatory ventilation. Other RCTs suggest that early extubation with the back-up institution of noninvasive positive-pressure ventilation as needed may be a useful strategy in selected patients.

ARTICLE TITLE: Mechanical ventilator weaning protocols driven by nonphysician health-care professionals: evidence-based clinical practice guidelines.
ARTICLE SOURCE: Chest (United States), Dec 2001, 120(6 Suppl) p454S-63S
AUTHOR(S): Ely EW; Meade MO; Haponik EF; Kollef MH; Cook DJ; Guyatt GH; Stoller JK
AUTHOR'S ADDRESS: Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-8300, USA. wes.ely@mcmail.vanderbilt.edu.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
For patients who pass the spontaneous breathing trial (SBT), the decision to extubate must be guided by clinical judgment and objective data to minimize the risk of unnecessary reintubations and self-extubations.

ARTICLE TITLE: Ventilator modes used in weaning.
ARTICLE SOURCE: Chest (United States), Dec 2001, 120(6 Suppl) p474S-6S
AUTHOR(S): Hess D
AUTHOR'S ADDRESS: Respiratory Care, Massachusetts General Hospital, Boston, MA 02114, USA. dhess@partners.org.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
ABSTRACT: Weaning techniques include spontaneous breathing trials (SBTs), pressure-support ventilation (PSV), and synchronized intermittent mandatory ventilation (SIMV. Although new ventilator modes have been introduced to facilitate weaning, to date there is no evidence to support the use of these modes. Noninvasive positive-pressure ventilation also has been reported to facilitate weaning, but the ability to generalize these findings remains to be determined.

ARTICLE TITLE: Weaning protocols: here to stay.
ARTICLE SOURCE: Lancet (England), Jan 19 2002, 359(9302) p186-7
AUTHOR(S): Keenan SP
AUTHOR'S ADDRESS: Intensive Care Unit, Royal Columbian Hospital, BC V3L 5E7, New Westminster, Canada. Sean_Keenan@telus.net.
PUBLICATION TYPE Journal Article

ARTICLE TITLE: Trials of corticosteroids to prevent postextubation airway complications.
ARTICLE SOURCE: Chest (United States), Dec 2001, 120(6 Suppl) p464S-8S
AUTHOR(S): Meade MO; Guyatt GH; Cook DJ; Sinuff T; Butler R
AUTHOR'S ADDRESS: Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
PUBLICATION TYPE: Journal Article; Meta-Analysis
Overall, we found that corticosteroids decreased the risk of postextubation stridor in children by about 40%. However, the effect of corticosteroids in children and adults to reduce postextubation complications such as reintubation is uncertain.

ARTICLE TITLE: The risk of hospitalization and near-fatal and fatal asthma in relation to the perception of dyspnea ARTICLE SOURCE: Chest (United States), Feb 2002, 121(2) p329-33
AUTHOR(S): Magadle R; Berar-Yanay N; Weiner P
AUTHOR'S ADDRESS: Department of Medicine A, Hillel-Yaffe, Medical Center, Hadera, Israel.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Approximately 26% of the referral subjects with asthma had low perception of dyspnea (POD) when compared to healthy matched subjects. Patients with low POD had statistically significantly more emergency department (ED) visits, hospitalizations, near-fatal asthma attacks, and deaths during the follow-up period. Reduced POD may predispose patients to a life-threatening attack.

ARTICLE TITLE: Defining dyspnea
ARTICLE SOURCE: Chest (United States), Feb 2002, 121(2) p662-9
AUTHOR(S): Govindaraj M
AUTHOR'S ADDRESS: Calicut, Kerala State, India. Washington University School of Medicine St. Louis, MO.
PUBLICATION TYPE Journal Article

ARTICLE TITLE: Comparison of cardiac output and circulatory blood volumes by transpulmonary thermo-dye dilution and transcutaneous indocyanine green measurement in critically ill patients
ARTICLE SOURCE: Chest (United States), Feb 2002, 121(2) p559-65
AUTHOR(S): Sakka SG; Reinhart K; Wegscheider K; Meier-Hellmann A
AUTHOR'S ADDRESS: Department of Anesthesiology and Intensive Care Medicine, Friedrich-Schiller-University of Jena, Jena, Germany. Samir.Sakka@med.uni-jena.de.
PUBLICATION TYPE: Journal Article
CONCLUSION: Pulse dye densitometry (PDD) measurement of cardiac output and circulatory blood volumes agrees moderately with transpulmonary thermo-dye dilution technique in critically ill patients.

ARTICLE TITLE: Domiciliary-assisted ventilation in patients with myotonic dystrophy
ARTICLE SOURCE: Chest (United States), Feb 2002, 121(2) p459-64
AUTHOR(S): Nugent AM; Smith IE; Shneerson JM
AUTHOR'S ADDRESS: Respiratory Support and Sleep Center, Papworth Hospital, Papworth Everard, Cambridge, United Kingdom.
PUBLICATION TYPE: Journal Article
CONCLUSION: Use of domiciliary-assisted ventilation in patients with myotonic dystrophy is associated with prolonged survival and a sustained improvement in arterial blood gas tensions.

ARTICLE TITLE: Noninvasive mechanical ventilation at home : building upon the tradition
ARTICLE SOURCE: Chest (United States), Feb 2002, 121(2) p321-4
AUTHOR(S): Goldberg AI
AUTHOR'S ADDRESS: Dr. Goldberg is Professor of Pediatrics, Loyola University, Chicago.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Pink Puffers vs Blue Bloaters in Asthma Too?
ARTICLE SOURCE: Chest (United States), Feb 2002, 121(2) p313-5
AUTHOR(S): Aldrich TK
AUTHOR'S ADDRESS: Dr. Aldrich is Professor and Chief, Pulmonary Medicine Division, Montefiore Medical Center and Albert Einstein College of Medicine.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: The management of the agitated ICU patient.
ARTICLE SOURCE: Crit Care Med (United States), Jan 2002, 30(1 Suppl Management) pS97-123; quiz S124-25
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Optimizing timing of ventricular defibrillation.
COMMENTS: Comment In: Comment In: RefSource:Crit Care Med. 2001 Dec; 29(12):2395-7
ARTICLE SOURCE: Crit Care Med (United States), Dec 2001, 29(12) p2360-5
AUTHOR(S): Marn-Pernat A; Weil MH; Tang W; Pernat A; Bisera J
AUTHOR'S ADDRESS: Institute of Critical Care Medicine, Palm Springs, CA, USA.
PUBLICATION TYPE: Journal Article
CONCLUSION: amplitude spectrum area (AMSA). has the potential for guiding more optimal timing of defibrillation without adverse interruption of cardiopulmonary resuscitation or the delivery of unsuccessful high energy electrical shocks that contribute to postresuscitation myocardial injury.

ARTICLE TITLE: Limited effectiveness of intraoperative autotransfusion in major back surgery.
ARTICLE SOURCE: Eur J Anaesthesiol (England), Dec 2001, 18(12) p823-8
AUTHOR(S): Abildgaard L; Aaro S; Lisander B
AUTHOR'S ADDRESS: Department of Anaesthesia, University Hospital, S-581 85 Linkoping, Sweden.
PUBLICATION TYPE: Journal Article
CONCLUSION: The efficiency of the autotransfusion device was relatively low in relation to the total extravasation, mainly because the postoperative blood loss is substantial.

ARTICLE TITLE: Which patient should be referred to an electrophysiologist: supraventricular tachycardia.
ARTICLE SOURCE: Heart (England), Mar 2002, 87(3) p299-304
AUTHOR(S): Schilling RJ
AUTHOR'S ADDRESS: Cardiology Department, St Barts Hospital, West Smithfield. London EC1 7BE, UK. richard.schilling@bartsandthelondon.nhs.uk.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
MB: Only about supra-ventricular problems.

ARTICLE TITLE: The need for palliative care in the management of heart failure.
ARTICLE SOURCE: Heart (England), Mar 2002, 87(3) p294-8
AUTHOR(S): Ward C
AUTHOR'S ADDRESS: Heart Failure Clinic, South Manchester University Hospital NHS Trust, Southmoor Road, Manchester M23 9LT, UK. chris.ward@smuht.nwest.nhs.uk.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Effect of allopurinol on mortality and hospitalisations in chronic heart failure: a retrospective cohort study.
ARTICLE SOURCE: Heart (England), Mar 2002, 87(3) p229-34
AUTHOR(S): Struthers AD; Donnan PT; Lindsay P; McNaughton D; Broomhall J; MacDonald TM
AUTHOR'S ADDRESS: Department of Clinical Pharmacology & Therapeutics, and the Medicines Monitoring Unit, Ninewells Hospital, Dundee DD1 9SY, UK. a.d.struthers@dundee.ac.uk.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Long term high dose allopurinol may be associated with a better mortality than long term low dose allopurinol in patients with chronic heart failure (CHF) because of a dose related beneficial effect of allopurinol against the well described adverse effect of urate. Further work is required to substantiate or refute this finding.

ARTICLE TITLE: Mechanical reperfusion therapy for acute myocardial infarction: Stent PAMI, ADMIRAL, CADILLAC and beyond.
ARTICLE SOURCE: Heart (England), Mar 2002, 87(3) p191-2
AUTHOR(S): Brodie BR; Stuckey TD
PUBLICATION TYPE: Editorial

ARTICLE TITLE: Inhibition of temporary pacing by a mobile phone.
ARTICLE SOURCE: Heart (England), Feb 2002, 87(2) p130
AUTHOR(S): Betts TR; Simpson IA
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: "Diastolic heart failure" or heart failure caused by subtle left ventricular systolic dysfunction?
ARTICLE SOURCE: Heart (England), Jan 2002, 87(1) p29-31
AUTHOR(S): Petrie MC; Caruana L; Berry C; McMurray JJ
AUTHOR'S ADDRESS: Department of Cardiology, Western Infirmary of Glasgow, Glasgow, UK.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Approximately one quarter of patients with suspected heart failure but preserved systolic function by conventional methods have abnormal atrioventricular plane displacement. These patients with suspected heart failure but preserved systolic function by conventional echocardiographic measures may have heart failure caused by subtle systolic dysfunction rather than isolated "diastolic heart failure"
MB: I hope they get the definition of cardiac failure straight soon.

ARTICLE TITLE: Left ventricular long axis function in diastolic heart failure is reduced in both diastole and systole: time for a redefinition?
ARTICLE SOURCE: Heart (England), Feb 2002, 87(2) p121-5
AUTHOR(S): Yip G; Wang M; Zhang Y; Fung JW; Ho PY; Sanderson JE
AUTHOR'S ADDRESS: Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: In patients with diastolic heart failure and evidence of left ventricular hypertrophy, there is systolic left ventricular impairment as measured by myocardial Doppler imaging of the longitudinal axis. Thus subtle abnormalities of systolic function are present in patients with heart failure and a normal left ventricular ejection fraction, and there appears to be a continuum of systolic function between those with truly normal, mildly impaired (labelled diastolic heart failure), and obviously abnormal left ventricular systolic function. Isolated diastolic dysfunction is uncommon.
MB: Sounds like gobble-di-gook to me.

ARTICLE TITLE: Anaesthesia and the cardiac patient: the patient versus the procedure.
ARTICLE SOURCE: Heart (England), Jan 2002, 87(1) p91-6
AUTHOR(S): Froehlich JB; Eagle KA
AUTHOR'S ADDRESS: UMass Memorial Medical Center, University of Massachusetts Medical School, Division of Cardiovascular Medicine, University Campus, 55 Lake Avenue North, Worcester, MA 01655, USA. froehlij@ummhc.org.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Taking up regular drinking in middle age: effect on major coronary heart disease events and mortality.
ARTICLE SOURCE: Heart (England), Jan 2002, 87(1) p32-6
AUTHOR(S): Wannamethee SG; Shaper AG
AUTHOR'S ADDRESS: Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London NW3 2PF, UK. goya@pcps.ucl.ac.uk.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Middle aged new regular drinkers experienced lower risk of major coronary heart disease events than stable occasional drinkers or non-drinkers, but had increased risk of non-cardiovascular mortality and total mortality. These findings provide little support for encouraging older men who do not drink or who only drink occasionally to take up regular drinking, whether or not they have coronary heart disease.
MB: Well there you go.

ARTICLE TITLE: Myocardial viability: impact on left ventricular dilatation after acute myocardial infarction.
ARTICLE SOURCE: Heart (England), Jan 2002, 87(1) p17-22
AUTHOR(S): Nijland F; Kamp O; Verhorst PM; de Voogt WG; Bosch HG; Visser CA
AUTHOR'S ADDRESS: Department of Cardiology and Institute for Cardiovascular Research, Free University Hospital, PO Box 7057, 1007 MB Amsterdam, Netherlands. cardiol@azvu.nl.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The presence of viability early after acute myocardial infarction is associated with preservation of left ventricular size, whereas the absence of viability results in ventricular dilatation, particularly in large infarcts.

ARTICLE TITLE: Preoperative hemoglobin levels and the need for transfusion after prosthetic hip and knee surgery : analysis of predictive factors
ARTICLE SOURCE: J Bone Joint Surg Am (United States), Feb 2002, 84-A(2) p216-20
AUTHOR(S): Salido JA; Marin LA; Gomez LA; Zorrilla P; Martinez C
PUBLICATION TYPE: Status: In-Process
Journal Article
CONCLUSIONS: The preoperative hemoglobin level (p = 0.0001) and weight of the patient (p = 0.011) were shown to predict the need for blood transfusion after hip and knee replacement.

ARTICLE TITLE: Injuries to the cervical spine in american football players
ARTICLE SOURCE: J Bone Joint Surg Am (United States), Jan 2002, 84-A(1) p112-22
AUTHOR(S): Torg JS; Guille JT; Jaffe S
PUBLICATION TYPE: Journal Article
MB: Do they have scrums too?

ARTICLE TITLE: Erythrocyte viability in blood salvaged during total joint arthroplasty with cement
ARTICLE SOURCE: J Bone Joint Surg Am (United States), Jan 2002, 84-A(1) p23-5
AUTHOR(S): Colwell CW; Beutler E; West C; Hardwick ME; Morris BA
AUTHOR'S ADDRESS: Scripps Clinic, La Jolla, CA 92037, USA. colwell@scripps.edu.
PUBLICATION TYPE: Status: In-Process
Journal Article
CONCLUSIONS: The high rate of viability of the erythrocytes in this study shows that the Cell Saver is a valuable adjunct to other blood management techniques for patients having total joint arthroplasty. We believe that the very high mean rate of erythrocyte viability and the extremely small standard deviation in our three subjects, as compared with the standards of the American Association of Blood Banks, made additional study subjects unnecessary.

ARTICLE TITLE: Why do gay men want to be vaccinated against hepatitis B? An assessment of psychosocial determinants of vaccination intention
ARTICLE SOURCE: Int J STD AIDS (England), Feb 2002, 13(2) p86-90
AUTHOR(S): Schutten M; de Wit JB; van Steenbergen JE
AUTHOR'S ADDRESS: Municipal Health Service Amsterdam, HIV & STI Research, PO Box 2200, 1000 CE Amsterdam.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Sexual behaviour in a low-income high school setting in Stockholm
ARTICLE SOURCE: Int J STD AIDS (England), Mar 2002, 13(3) p160-7
AUTHOR(S): Edgardh K
AUTHOR'S ADDRESS: Department of Venhalsan, Karolinska Institute, Soder Hospital, Stockholm, Sweden.
PUBLICATION TYPE: Status: In-Process
Journal Article
ABSTRACT: Teenage abortions and sexually transmitted infections (STIs) are increasing in Sweden, and risky adolescent sexual behaviour is an issue of major concern. The aim of the present cross-sectional questionnaire-based study was to investigate adolescent sexual experience in a low-income high school setting in Stockholm. Among 340 students, 258 participated, response rate=75.9%, mean age=17 years. Homo- or bisexual preference was reported by 11.6% (29/250). Experience of oral sex was reported by 66.3% (163/246), vaginal intercourse by 55.5% (141/254), and anal sex by 10.0% (25/250), with no gender-specific differences. Five or more coital partners were reported by 29.8% (34/114). Condom use at first and most recent intercourse was reported by 61.7% (87/141) and 42.6% (60/141), respectively, and condom breakage by 39.5% (34/86). Truancy, smoking, alcohol and drug use were factors associated with coital experience. Sexual abuse was reported by 2.2% (3/134) of the boys and 13.0% (16/123) of the girls.
MB: I did not know they had low income people in Sweden.

ARTICLE TITLE: Sexual behaviour in Britain: early heterosexual experience.
COMMENTS: Comment In: Comment In: RefSource:Lancet. 2001 Dec 1; 358(9296):1828-9/PMID:11741616
ARTICLE SOURCE: Lancet (England), Dec 1 2001, 358(9296) p1843-50
AUTHOR(S): Wellings K; Nanchahal K; Macdowall W; McManus S; Erens B; Mercer CH; Johnson AM; Copas AJ; Korovessis C; Fenton KA; Field J
AUTHOR'S ADDRESS: Centre for Sexual Health Research, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK. kaye.wellings@lshtm.ac.uk.
PUBLICATION TYPE: Journal Article
INTERPRETATION: The increase in the proportion of women reporting first intercourse before age 16 years does not appear to have continued throughout the past decade. Only a small minority of teenagers have unprotected first intercourse, and early motherhood is more strongly associated with educational level than with family background. Factors most strongly associated with risk behaviour and adverse outcomes have considerable potential for preventive intervention.

ARTICLE TITLE: Editorial: The mystery--and importance--of diabetic atherosclerotic vascular disease.
COMMENTS: Comment On: Comment On: RefSource:J Clin Endocrinol Metab. 2002 Jan; 87(1):35-40/
ARTICLE SOURCE: J Clin Endocrinol Metab (United States), Jan 2002, 87(1) p33-4
AUTHOR(S): Williams KJ
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Motor vehicle restraints: primary versus secondary enforcement and ethnicity.
ARTICLE SOURCE: J Trauma (United States), Feb 2002, 52(2) p225-8
AUTHOR(S): Davis JW; Bennink L; Kaups KL; Parks SN
AUTHOR'S ADDRESS: Department of Surgery, University of California at San Francisco/Fresno, Fresno, California, USA.
PUBLICATION TYPE: Journal Article; Multicenter Study
METHODS: Data were collected on motor vehicle crash victims admitted to two Level I trauma centers from October 1, 1997, through March 31, 1998; one in a state with primary restraint enforcement (motorist can be stopped for the restraint violation), the other with a secondary restraint law (restraint violation may be enforced if the motorist is stopped for another violation). CONCLUSION: In a state with secondary enforcement laws, restraint use varied significantly with ethnicity. Restraint use was markedly increased in all ethnic groups by the presence of a primary enforcement law. Implementation and enforcement of primary restraint laws is essential to improving motor vehicle restraint use. Educational campaigns to increase restraint use need to target specific populations.

ARTICLE TITLE: Aggressive driving: a preliminary analysis of a serious threat to motorists in a large metropolitan area.
ARTICLE SOURCE: J Trauma (United States), Feb 2002, 52(2) p217-23; discussion 223-4
AUTHOR(S): Fakhry SM; Salaita K
AUTHOR'S ADDRESS: Trauma Services, Inova Regional Trauma Center, Inova Fairfax Hospital, Falls Church, Virginia 22042-3300, USA; Collective Name: Smooth Operator Aggressive Driving Task Force.
PUBLICATION TYPE: Journal Article
CONCLUSION: Aggressive driving behaviors are frequent and often include very dangerous actions. Currently available deterrents appear to have limited impact in our congested area. Inadequate resources for enforcement and limited public awareness may be partially responsible. We have adopted a multidisciplinary approach to this serious problem including public education, stepped-up enforcement, and psychological treatments.

ARTICLE TITLE: Successful use of recombinant activated factor VII for trauma-associated hemorrhage in a patient without preexisting coagulopathy.
ARTICLE SOURCE: J Trauma (United States), Feb 2002, 52(2) p400-5
AUTHOR(S): O'Neill PA; Bluth M; Gloster ES; Wali D; Priovolos S; Di Maio TM; Essex DW; Catanese CA; Strauss RA
AUTHOR'S ADDRESS: Division of Trauma, Department of Surgery, SUNY Health Science Center and Kings County Hospital Center, Brooklyn, New York 11203, USA. paoneill@pol.net.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Immediate endovascular stent graft repair of acute thoracic aortic rupture due to blunt trauma.
ARTICLE SOURCE: J Trauma (United States), Jan 2002, 52(1) p154-7
AUTHOR(S): Gan JP; Campbell WA
AUTHOR'S ADDRESS: Vascular Unit, The Alfred Hospital, Melbourne, Australia.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Endovascular carotid stenting after trauma.
ARTICLE SOURCE: J Trauma (United States), Jan 2002, 52(1) p149-53
AUTHOR(S): Duane TM; Parker F; Stokes GK; Parent FN; Britt LD
AUTHOR'S ADDRESS: Department of Surgery, Eastern Virginia Medical School, Norfolk, Virginia 23507, USA.
PUBLICATION TYPE: Journal Article
MB: 2 post-trauma cases. We are still waiting for a suitable case. Our main surgeon has done 2 while a visitor else where. A few have been done in Sydney.

ARTICLE TITLE: Helicopter transport and blunt trauma mortality: a multicenter trial.
ARTICLE SOURCE: J Trauma (United States), Jan 2002, 52(1) p136-45
AUTHOR(S): Thomas SH; Harrison TH; Buras WR; Ahmed W; Cheema F; Wedel SK
AUTHOR'S ADDRESS: Boston MedFlight Critical Care Transport Service, Boston, Massachusetts 01730, USA.
PUBLICATION TYPE: Journal Article; Multicenter Study
CONCLUSION: The results of this study are consistent with an association between helicopter transport mode and increased survival in blunt trauma patients.

ARTICLE TITLE: The LMA-unique in a prehospital trauma patient: interaction with a semirigid cervical collar: a case report.
ARTICLE SOURCE: J Trauma (United States), Jan 2002, 52(1) p162-4
AUTHOR(S): Matioc AA; Wells JA
AUTHOR'S ADDRESS: Anesthesiology Service, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705, USA. aamatioc@facstaff.wisc.edu.
PUBLICATION TYPE: Journal Article
MB: After failed intubation

ARTICLE TITLE: Skeletal muscle acidosis correlates with the severity of blood volume loss during shock and resuscitation.
ARTICLE SOURCE: J Trauma (United States), Dec 2001, 51(6) p1137-45; discussion 1145-6
AUTHOR(S): Sims C; Seigne P; Menconi M; Monarca J; Barlow C; Pettit J; Puyana JC
AUTHOR'S ADDRESS: Harvard Center for Minimally Invasive Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
PUBLICATION TYPE: Journal Article
CONCLUSION: Continuous multiparameter monitoring of skeletal muscle (SM) provides a minimally invasive method for assessing severity of shock and efficacy of resuscitation. Both PCO2 and PO2 levels change rapidly with shock and resuscitation. SM pH is directly proportional to lost blood volume. Persistent SM acidosis (pH < 7.2) and elevated PCO2 levels suggest incomplete resuscitation despite normalized hemodynamics.

ARTICLE TITLE: Ventilator-associated pneumonia in the surgical intensive care unit.
ARTICLE SOURCE: J Trauma (United States), Dec 2001, 51(6) p1207-16
AUTHOR(S): Brown DL; Hungness ES; Campbell RS; Luchette FA
AUTHOR'S ADDRESS: Bernard O'Brien Institute, Melbourne, Australia.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Reverse Trendelenburg position reduces intracranial pressure during craniotomy.
ARTICLE SOURCE: J Neurosurg Anesthesiol (United States), Jan 2002, 14(1) p16-21
AUTHOR(S): Rolighed Larsen JK; Haure P; Cold GE
AUTHOR'S ADDRESS: Department of Neuroanesthesiology, Aarhus Kommunehospital, Aarhus University Hospital, Denmark.
PUBLICATION TYPE: Journal Article
MB: That is pretty old hat.

ARTICLE TITLE: Bispectral Index (BIS) may not predict awareness reaction to intubation in surgical patients.
ARTICLE SOURCE: J Neurosurg Anesthesiol (United States), Jan 2002, 14(1) p7-11
AUTHOR(S): Schneider G; Wagner K; Reeker W; Hanel F; Werner C; Kochs E
AUTHOR'S ADDRESS: Department of Anesthesiology, Technische Universitat Munchen, Munich, Germany.
PUBLICATION TYPE: Journal Article
ABSTRACT: Bispectral Index (BIS) has been marketed as a measure of the hypnotic component of anesthesia and is recommended as a guide for the administration of hypnotic drugs during anesthesia<snip> Prior to intubation, patients were tested in one-minute intervals for awareness using Tunstall's isolated forearm technique. Three minutes after endotracheal intubation, the study period ended and surgery was performed. After intubation, 8 of 20 patients showed an awareness reaction, squeezing the investigator's hand in response to a command. No patient had recall<snip> Because BIS cannot differentiate between patients with and without awareness reaction, its value as a monitor for awareness and a measurement of the hypnotic component of anesthesia must be questioned.
MB: Marketing should have waited until after such tests.

ARTICLE TITLE: Free radicals, antioxidants, and neurologic injury: possible relationship to cerebral protection by anesthetics.
ARTICLE SOURCE: J Neurosurg Anesthesiol (United States), Jan 2002, 14(1) p66-79
AUTHOR(S): Wilson JX; Gelb AW
AUTHOR'S ADDRESS: Department of Physiology, University of Western Ontario, London, Ontario, Canada.
PUBLICATION TYPE: Status: Completed
Journal Article; Review; Review, Academic
ABSTRACT: Oxygen-centered free radicals cause brain injury associated with trauma and stroke. These reactive oxygen species may be detoxified by endogenous antioxidants, but cell death occurs after antioxidants become depleted. General anesthetics penetrate into brain parenchyma, where they may abrogate oxidative injury to neurons by several mechanisms that prevent the initiation of free radical chain reactions or terminate the propagation of highly reactive radicals. First, general anesthetics may inhibit free radical generation because these drugs slow cerebral utilization of oxygen and glucose, inhibit oxidative metabolism in neutrophils, and prevent redox changes in hemoglobin. Second, antioxidant anesthetics, such as thiopental and propofol, directly scavenge reactive oxygen species and inhibit lipid peroxidation. Finally, anesthetics may prevent the elevation of extracellular glutamate concentration and inhibit the activation of excitatory glutamatergic receptors that augment oxidative stress after ischemia.
MB: Not a very definite endorsement.

ARTICLE TITLE: Intracranial effects of endotracheal suctioning in the acute phase of head injury.
ARTICLE SOURCE: J Neurosurg Anesthesiol (United States), Jan 2002, 14(1) p50-4
AUTHOR(S): Gemma M; Tommasino C; Cerri M; Giannotti A; Piazzi B; Borghi T
AUTHOR'S ADDRESS: University of Milano, Institute of Anesthesiology and Intensive Care, Neurointensive Care Unit, IRCCS San Raffaele Hospital, Milano, Italy.
PUBLICATION TYPE: Journal Article
In well-sedated patients, endotracheal suctioning caused an increase in increase intracranial pressure (ICP), cerebral perfusion pressure (CPP), and jugular oxygen saturation (S(j)O2without evidence of ischemia. In contrast, in patients who coughed or moved in response to suctioning, there was a slight and significant decrease in CPP and S(j)O2. In the case of patients with head injuries who coughed or moved during endotracheal suctioning, we strongly suggest deepening the level of sedation before completing the procedure to reduce the risk of adverse effects.

ARTICLE TITLE: US government undercuts Oregon's assisted-suicide law.
ARTICLE SOURCE: Lancet (England), Nov 24 2001, 358(9295) p1788
AUTHOR(S): McLellan F
PUBLICATION TYPE: News
MB: A bit like here. Federal drug regulators are going to restrict licences to prescribe restricted drugs. That is a state matter here.

ARTICLE TITLE: New group to look at helping the sick doctors of Europe.
ARTICLE SOURCE: Lancet (England), Nov 17 2001, 358(9294) p1707
AUTHOR(S): Bosch X
PUBLICATION TYPE: News

ARTICLE TITLE: Australian Aboriginal leaders tackle welfare of indigenous population.
ARTICLE SOURCE: Lancet (England), Dec 22-29 2001, 358(9299) p2138
AUTHOR(S): Loff B; Cordner S
PUBLICATION TYPE: News

ARTICLE TITLE: War, bioterrorism, and the political landscape.
ARTICLE SOURCE: Lancet (England), Dec 22-29 2001, 358(9299) p2137
AUTHOR(S): Greenberg DS
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Near-death experience in survivors of cardiac arrest: a prospective study in the Netherlands.
COMMENTS: Comment In: Comment In: RefSource:Lancet. 2001 Dec 15; 358(9298):2010-1/PMID:11755600
ARTICLE SOURCE: Lancet (England), Dec 15 2001, 358(9298) p2039-45
AUTHOR(S): van Lommel P; van Wees R; Meyers V; Elfferich I
AUTHOR'S ADDRESS: Division of Cardiology, Hospital Rijnstate, Arnhem, Netherlands. pimvanlommel@wanadoo.nl.
PUBLICATION TYPE: Journal Article
INTERPRETATION: We do not know why so few cardiac patients report near-death experience (NDE) after one cardiopulmonary resuscitation (CPR), although age plays a part. With a purely physiological explanation such as cerebral anoxia for the experience, most patients who have been clinically dead should report one.
MB: I would think that memories during onset and recovery would explain experiences. I remember nothing from the time of my arrest until about 24 hours after extubation. During that 24hrs I understand I had a lot to say.

ARTICLE TITLE: Dying to know the truth: visions of a dying brain, or false memories?
COMMENTS: Comment On: Comment On: RefSource:Lancet. 2001 Dec 15; 358(9298):2039-45
ARTICLE SOURCE: Lancet (England), Dec 15 2001, 358(9298) p2010-1
AUTHOR(S): French CC
AUTHOR'S ADDRESS: Anomalistic Psychology Research Unit, Goldsmiths College, University of London, SE14 6NW, London, UK. c.french@gold.ac.uk.
PUBLICATION TYPE: Comment; Journal Article

ARTICLE TITLE: Privacy for patients who are health-care workers.
ARTICLE SOURCE: Lancet (England), Dec 8 2001, 358(9297) p1919
PUBLICATION TYPE: Editorial
MB: They tell me many tried to access my records.

ARTICLE TITLE: "Dangerousness" and dangerous law.
COMMENTS: Comment On: Comment On: RefSource:Lancet. 2001 Dec 8; 358(9297):1955-9/PMID:11747920
ARTICLE SOURCE: Lancet (England), Dec 8 2001, 358(9297) p1926
AUTHOR(S): Farnham FR; James DV
AUTHOR'S ADDRESS: Department of Psychiatry and Behavioural Science, Royal Free and University College London Medical School, Royal Free Campus, NW3 2PF, London, UK.
PUBLICATION TYPE: Comment; Journal Article
MB: About definitions of psychiatric diagnoses.

ARTICLE TITLE: Taxation and the UK NHS--not if but when? National Health Service.
ARTICLE SOURCE: Lancet (England), Dec 8 2001, 358(9297) p1971
AUTHOR(S): Dean M
PUBLICATION TYPE: News

ARTICLE TITLE: Renoprotection by angiotensin-receptor blockers and ACE inhibitors in hypertension.
ARTICLE SOURCE: Lancet (England), Dec 1 2001, 358(9296) p1829-31
AUTHOR(S): Opie LH
AUTHOR'S ADDRESS: Cape Heart Centre, Department of Medicine, University of Cape Town, 7925, Cape Town, South Africa. Opie@Capeheart.uct.ac.za.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Laparoscopic living donor hepatectomy for liver transplantation in children.
COMMENTS: Comment In: Comment In: RefSource:Lancet. 2002 Feb 2; 359(9304):368-70
ARTICLE SOURCE: Lancet (England), Feb 2 2002, 359(9304) p392-6
AUTHOR(S): Cherqui D; Soubrane O; Husson E; Barshasz E; Vignaux O; Ghimouz M; Branchereau S; Chardot C; Gauthier F; Fagniez PL; Houssin D
AUTHOR'S ADDRESS: Department of General and Digestive Surgery, Hopital Henri Mondor 94010, Creteil, France. daniel.cherqui@hmn.ap-hop-paris.fr.
PUBLICATION TYPE: Journal Article
INTERPRETATION: We have shown the feasibility of laparoscopic living donor hepatectomy from parent to child. If the safety and feasibility of this procedure can be shown in larger series, laparoscopic donor left lobectomy could become a new option for paediatric living donor liver transplantation.
MB: There have been deaths in donors. One was reported in Time.

ARTICLE TITLE: Impact of surgical innovation on liver transplantation.
COMMENTS: Comment On: Comment On: RefSource:Lancet. 2002 Feb 2; 359(9304):392-6; Comment On: Comment On: RefSource:Lancet. 2002 Feb 2; 359(9304):406-7
ARTICLE SOURCE: Lancet (England), Feb 2 2002, 359(9304) p368-70
AUTHOR(S): Grewal HP
AUTHOR'S ADDRESS: Department of Surgery, University of Tennessee, Memphis, TN 38163, USA. hgrewal@utmem.edu.
PUBLICATION TYPE Comment; Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Coronary reperfusion: numerators searching for denominators.
COMMENTS: Comment On: Comment On: RefSource:Lancet. 2002 Feb 2; 359(9304):373-7
ARTICLE SOURCE: Lancet (England), Feb 2 2002, 359(9304) p371-2
AUTHOR(S): Armstrong PW
AUTHOR'S ADDRESS: Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2H7, Canada. paul.armstrong@ualberta.ca.
PUBLICATION TYPE: Comment; Journal Article

ARTICLE TITLE: Munchausen's syndrome.
ARTICLE SOURCE: Lancet (England), Jan 26 2002, 359(9303) p346-9
AUTHOR(S): Turner J; Reid S
AUTHOR'S ADDRESS: Springfield University Hospital, London, UK.
PUBLICATION TYPE: Status: Completed
Biography; Historical Article; Journal Article

ARTICLE TITLE: Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial.
ARTICLE SOURCE: Lancet (England), Jan 19 2002, 359(9302) p204-10
AUTHOR(S): Pepperell JC; Ramdassingh-Dow S; Crosthwaite N; Mullins R; Jenkinson C; Stradling JR; Davies RJ
AUTHOR'S ADDRESS: Oxford Sleep Unit and Respiratory Trials Unit, Oxford Centre for Respiratory Medicine, Churchill Hospital Site, Oxford Radcliffe Hospital, OX3 7LJ, Oxford, UK. robert.davies@ndm.ox.ac.uk.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
INTERPRETATION: In patients with most severe sleep apnoea, nasal continuous positive airway pressure (nCPAP) reduces blood pressure, providing significant vascular risk benefits, and substantially improving excessive daytime sleepiness and quality of life.

ARTICLE TITLE: No reduction in cardiovascular risk with NSAIDs-including aspirin?
COMMENTS: Comment On: Comment On: RefSource:Lancet. 2002 Jan 12; 359(9301):118-23/PMID:11809254
ARTICLE SOURCE: Lancet (England), Jan 12 2002, 359(9301) p92-3
AUTHOR(S): Cleland JG
AUTHOR'S ADDRESS: Department of Cardiology, University of Hull, HU16 5JQ, Kingston upon Hull, UK. j.g.cleland@medschool.hull.ac.uk.
PUBLICATION TYPE: Comment; Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial.
ARTICLE SOURCE: Lancet (England), Jan 12 2002, 359(9301) p114-7
AUTHOR(S): Moller AM; Villebro N; Pedersen T; Tonnesen H
AUTHOR'S ADDRESS: Department of Anaesthesiology, Bispebjerg University Hospital, 2400 NV, Copenhagen, Denmark. docamm@yahoo.com.
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
INTERPRETATION: An effective smoking intervention programme 6-8 weeks before surgery reduces postoperative morbidity, and we recommend, on the basis of our results, this programme be adopted.

ARTICLE TITLE: Mind-body medicine. An introduction and review of the literature.
ARTICLE SOURCE: Med Clin North Am (United States), Jan 2002, 86(1) p11-31
AUTHOR(S): Barrows KA; Jacobs BP
AUTHOR'S ADDRESS: Osher Center for Integrative Medicine, University of California-San Francisco, San Francisco, California, USA. kb1@onebox.com.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: New law on male circumcision in Sweden
ARTICLE SOURCE: Lancet (England), Feb 16 2002, 359(9306) p630
AUTHOR(S): Hofvander Y
AUTHOR'S ADDRESS: International Maternal: In and Child Health, University Hospital, 751 85, Uppsala, Sweden.
PUBLICATION TYPE: Journal Article
MB: They seem to have gone over the top in Sweden.

ARTICLE TITLE: Hysterectomy rates in the United States 1990-1997.
ARTICLE SOURCE: Obstet Gynecol (United States), Feb 2002, 99(2) p229-34
AUTHOR(S): Farquhar CM; Steiner CA
AUTHOR'S ADDRESS: Centers for Practice and Technology Assessment, Agency for Healthcare Research and Quality, Rockville, Maryland, USA. c.farquhar@auckland.ac.nz.
PUBLICATION TYPE: Journal Article
CONCLUSION: The majority of hysterectomies are abdominal, and the most common indication is uterine fibroids. The introduction of alternative techniques for controlling abnormal uterine bleeding such as endometrial ablation has not had an impact on hysterectomy rates, and there has only been a limited uptake of laparoscopic approaches.

ARTICLE TITLE: Dose-range effects of propofol for reducing emetic symptoms during cesarean delivery.
ARTICLE SOURCE: Obstet Gynecol (United States), Jan 2002, 99(1) p75-9
AUTHOR(S): Fujii Y; Numazaki M
AUTHOR'S ADDRESS: Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine, Tsukuba City, Ibaraki, Japan. yfujii@igaka.md.tsukuba.ac.jp.
PUBLICATION TYPE: Journal Article
CONCLUSION: Propofol 1.0 mg/kg per hour is the minimum effective subhypnotic dose for reducing emetic symptoms during cesarean delivery. Increasing the dose to 2.0 mg/kg per hour provides no further benefit.

ARTICLE TITLE: Can regionalization decrease the number of deaths for children who undergo cardiac surgery? A theoretical analysis
ARTICLE SOURCE: Pediatrics (United States), Feb 2002, 109(2) p173-81
AUTHOR(S): Chang RK; Klitzner TS
AUTHOR'S ADDRESS: Division of Cardiology, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California 90509, USA. rkchang@ucla.edu.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Theoretical regionalization of pediatric cardiac surgery is associated with a reduction in surgical mortality from 5.34% to 4.08% when all cases were referred to high-volume hospitals, or decrease to 4.60% when high-risk cases were referred. Although regionalization is associated with an important decrease in the number of deaths, it also increases the travel distance for patients. Additional studies on the costs and benefits of regionalization are needed to determine the best strategies to improve outcomes for children who undergo cardiac surgery.

ARTICLE TITLE: The pulmonary physician in critical care 1: pulmonary investigations for acute respiratory failure.
ARTICLE SOURCE: Thorax (England), Jan 2002, 57(1) p79-85
AUTHOR(S): Dakin J; Griffiths M
AUTHOR'S ADDRESS: Unit of Critical Care, NHLI Division, Imperial College of Science, Technology & Medicine, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
ABSTRACT: This is the first in a series of reviews of the role of the pulmonary physician in critical care medicine. The investigation of mechanically ventilated patients is discussed, with particular reference to those presenting with acute respiratory failure and diffuse pulmonary infiltrates.

ARTICLE TITLE: The influence of hospital and surgeon volume on in-hospital mortality for colectomy, gastrectomy, and lung lobectomy in patients with cancer.
ARTICLE SOURCE: Surgery (United States), Jan 2002, 131(1) p6-15
AUTHOR(S): Hannan EL; Radzyner M; Rubin D; Dougherty J; Brennan MF
AUTHOR'S ADDRESS: Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, Rensselaer, NY 12144-3456, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: For all 3 procedure groups, the risk-adjusted in-hospital mortality is significantly lower when the procedures are performed by high-volume providers.

ARTICLE TITLE: Invited commentary: quality of care and the volume-outcome relationship--what's next for surgery?
ARTICLE SOURCE: Surgery (United States), Jan 2002, 131(1) p16-8
AUTHOR(S): Daley J
AUTHOR'S ADDRESS: Institute for Health Policy, Massachusetts General Hospital and Partners Healthcare System, Harvard Medical School, Boston, Mass. 02114, USA.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Invited commentary: Measure of competence
ARTICLE SOURCE: Surgery (United States), Feb 2002, 131(2) p210-1
AUTHOR(S): Trunkey D
AUTHOR'S ADDRESS: Department of Surgery, Oregon Health Sciences University, Portland, Ore.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Comparison of postoperative pain in patients receiving interscalene block or general anesthesia for shoulder surgery
ARTICLE SOURCE: Orthopedics (United States), Jan 2002, 25(1) p45-8
AUTHOR(S): Wu CL; Rouse LM; Chen JM; Miller RJ
AUTHOR'S ADDRESS: Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, NY, USA.
PUBLICATION TYPE: Status: In-Process
Journal Article
A higher percentage of patients who received regional anesthesia had a lower pain rating at 4 hours. Regional anesthesia for shoulder surgery decreases pain and facilitates recovery in the immediate postoperative period.

ARTICLE TITLE: Team physician-bad ethics, bad business, or both?
ARTICLE SOURCE: Orthopedics (United States), Jan 2002, 25(1) p16, 26
AUTHOR(S): Apple D
PUBLICATION TYPE: Editorial

ARTICLE TITLE: Hemoglobin level is an important determinant of Acid-base status in hemodialysis patients
ARTICLE SOURCE: Nephron (Switzerland), Jan 2002, 90(1) p111-3
AUTHOR(S): Borawski J; Mysliwiec M
AUTHOR'S ADDRESS: Department of Nephrology and Internal Medicine, Medical Academy, Bialystok, Poland.
PUBLICATION TYPE: Journal Article
MB: I would not have thought it was very important.

ARTICLE TITLE: From the Centers for Disease Control and Prevention. Evaluation of Bacillus anthracis contamination inside the Brentwood mail processing and distribution center--District of Columbia, October 2001.
ARTICLE SOURCE: JAMA (United States), Jan 23-30 2002, 287(4) p445-6
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Clinical trials are mandatory for improving surgical cancer care.
COMMENTS: Comment On: Comment On: RefSource:JAMA. 2002 Jan 16; 287(3):321-8
ARTICLE SOURCE: JAMA (United States), Jan 16 2002, 287(3) p377-8
AUTHOR(S): Petrelli NJ
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study.
ARTICLE SOURCE: JAMA (United States), Jan 16 2002, 287(3) p345-55
AUTHOR(S): Esteban A; Anzueto A; Frutos F; Alia I; Brochard L; Stewart TE; Benito S; Epstein SK; Apezteguia C; Nightingale P; Arroliga AC; Tobin MJ
AUTHOR'S ADDRESS: Unidad de Cuidados Intensivos, Hospital Universitario de Getafe, Carretera de Toledo Km 12, 5, 28905 Getafe, Madrid, Spain. aesteban@hug.es; Collective Name: Mechanical Ventilation International Study Group.
PUBLICATION TYPE: Journal Article; Multicenter Study
The main conditions independently associated with increased mortality were (1) factors present at the start of mechanical ventilation (odds ratio [OR], 2.98; 95% confidence interval [CI], 2.44-3.63; P<.001 for coma), (2) factors related to patient management (OR, 3.67; 95% CI, 2.02-6.66; P<.001 for plateau airway pressure >35 cm H(2)O), and (3) developments occurring over the course of mechanical ventilation (OR, 8.71; 95% CI, 5.44-13.94; P<.001 for ratio of PaO(2) to fraction of inspired oxygen <100). CONCLUSION: Survival among mechanically ventilated patients depends not only on the factors present at the start of mechanical ventilation, but also on the development of complications and patient management in the intensive care unit.
MB: What about elective ventilation after major surgery?

ARTICLE TITLE: Corticosteroid supplementation for adrenal insufficiency.
ARTICLE SOURCE: JAMA (United States), Jan 9 2002, 287(2) p236-40
AUTHOR(S): Coursin DB; Wood KE
AUTHOR'S ADDRESS: University of Wisconsin-Madison Medical School, 600 Highland Ave, B6/319 Clinical Science Center, Madison, WI 53792-3272, USA. dcoursin@facstaff.wisc.edu.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Defining and assessing professional competence.
COMMENTS: Comment In: Comment In: RefSource:JAMA. 2002 Jan 9; 287(2):243-4
ARTICLE SOURCE: JAMA (United States), Jan 9 2002, 287(2) p226-35
AUTHOR(S): Epstein RM; Hundert EM
AUTHOR'S ADDRESS: University of Rochester School of Medicine and Dentistry, 885 South Ave, Rochester, NY 14620, USA. ronald_epstein@urmc.rochester.edu.
PUBLICATION TYPE: Journal Article; Review; Review, Academic
CONCLUSIONS: In addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork promise a multidimensional assessment while maintaining adequate reliability and validity. Institutional support, reflection, and mentoring must accompany the development of assessment programs.
MB: We require more than promises. It really depends on the institutional activity rather than independent assessment of the individual.

ARTICLE TITLE: Skills assessment of surgeons
ARTICLE SOURCE: Surgery (United States), Feb 2002, 131(2) p121-4
AUTHOR(S): Darzi A; Mackay S
AUTHOR'S ADDRESS: Imperial College School of Medicine, St Mary's Hospital, London, United Kingdom.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: beta-Blocker therapy in heart failure: scientific review.
ARTICLE SOURCE: JAMA (United States), Feb 20 2002, 287(7) p883-9
AUTHOR(S): Foody JM; Farrell MH; Krumholz HM
AUTHOR'S ADDRESS: Yale University School of Medicine, New Haven, CT 06520-8025, USA.
PUBLICATION TYPE Journal Article; Review; Review, Academic
CONCLUSIONS: Tested in more than 10,000 patients, beta-blockers reduce morbidity and mortality in class II through IV heart failure. Along with angiotensin-converting enzyme inhibitors, digoxin, and diuretics, beta-blockers have strengthened the armamentarium to improve clinical outcomes of heart failure patients. The science supporting beta-blockers must be translated into practice safely and rationally if the agents are to achieve their full potential.

ARTICLE TITLE: beta-Blockers in heart failure: clinical applications.
ARTICLE SOURCE: JAMA (United States), Feb 20 2002, 287(7) p890-7
AUTHOR(S): Farrell MH; Foody JM; Krumholz HM
AUTHOR'S ADDRESS: Yale University School of Medicine, 333 Cedar St, PO Box 208025, New Haven, CT 06520-8025, USA.
PUBLICATION TYPE: Journal Article
ABSTRACT: beta-Blockers reduce morbidity and mortality in heart failure patients with left ventricular systolic dysfunction and stable fluid status. The successful adoption of beta-blocker guidelines for these patients requires an understanding of the value of this therapy and effective systems to maintain safety and ensure high quality of care. This article distills scientific evidence and consensus guidelines into a series of cases and practical answers about patient selection, discussions with patients, management and monitoring, and systems improvements to optimize quality of care, safety, and benefit for all patients with heart failure.

ARTICLE TITLE: Discussing religious and spiritual issues at the end of life: a practical guide for physicians.
ARTICLE SOURCE: JAMA (United States), Feb 13 2002, 287(6) p749-54
AUTHOR(S): Lo B; Ruston D; Kates LW; Arnold RM; Cohen CB; Faber-Langendoen K; Pantilat SZ; Puchalski CM; Quill TR; Rabow MW; Schreiber S; Sulmasy DP; Tulsky JA
AUTHOR'S ADDRESS: bernie@medicine.ucsf.edu; Collective Name: Working Group on Religious and Spiritual Issues at the End of Life.
PUBLICATION TYPE: Journal Article
Patients and families who feel that the physician understands them and cares about them may be more willing to consider the physician's views on prognosis and treatment. By responding to patients' spiritual and religious concerns and needs, physicians may help them find comfort and closure near the end of life.

ARTICLE TITLE: Medical management of advanced heart failure.
ARTICLE SOURCE: JAMA (United States), Feb 6 2002, 287(5) p628-40
AUTHOR(S): Nohria A; Lewis E; Stevenson LW
AUTHOR'S ADDRESS: Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Tower 3-A, Boston, MA 02115, USA.
PUBLICATION TYPE: Journal Article; Review; Review, Academic

ARTICLE TITLE: Paying for the NHS: are we asking the right question?
ARTICLE SOURCE: J R Soc Med (England), Feb 2002, 95(2) p59-60
AUTHOR(S): McKee M; Mossialos E; Dixon A
AUTHOR'S ADDRESS: European Observatory on Health Care Systems, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. European Observatory on Health Care Systems, LSE Health and Social Care, London School of Economics, London WC2A 2AE.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Clinical skills in final year medical students
ARTICLE SOURCE: J R Soc Med (England), Feb 2002, 95(2) p110
AUTHOR(S): Tucker B
AUTHOR'S ADDRESS: Alexandra Hospital, Woodrow Drive, Redditch B98 7UB, UK.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Revalidation of the retired: bad faith and a worse decision.
ARTICLE SOURCE: J R Soc Med (England), Jan 2002, 95(1) p46-7
AUTHOR(S): Vickers MD
AUTHOR'S ADDRESS: North Pines, 113 Cyncoed Road, Cardiff CF23 6AD, Wales, UK. md.vickers@virgin.net.
PUBLICATION TYPE: Journal Article
MB: The NSW Medical Board seem to have similar attitudes to the UK GSM.

ARTICLE TITLE: Can we improve on how we select medical students?
ARTICLE SOURCE: J R Soc Med (England), Jan 2002, 95(1) p18-22
AUTHOR(S): Hughes P
AUTHOR'S ADDRESS: Admissions Office, Hunter Wing, St George's Hospital Medical School, London SW17 0RE, UK. p.hughes@shgms.ac.uk.
PUBLICATION TYPE: Journal Article
MB: Apparently they are doing it badly now but the author thinks that having a national system they might do well.