MB's Articles of Interest - November 2002

ARTICLE TITLE: Prehospital advanced life support provided by specially trained physicians: is there a benefit in terms of life years gained?
ARTICLE SOURCE: Acta Anaesthesiol Scand (Denmark), Aug 2002, 46(7) p771-8
AUTHOR(S): Lossius HM; Soreide E; Hotvedt R; Hapnes SA; Eielsen OV; Forde OH; Steen PA
AUTHOR'S ADDRESS: Department of Anesthesia and Intensive Care, Rogaland Central Hospital, Stavanger, Norwegian Air Ambulance, Oslo, Norway. hamolo@online.no.
PUBLICATION TYPE: Journal Article
CONCLUSION: The expert panels found life years gained (LYG) in every 14th patient assisted by this anesthesiologist-manned prehospital emergency medical service (EMS). There was no difference in LYG between the helicopter and the rapid response car missions. The role of the anesthesiologist was crucial for health benefits.

ARTICLE TITLE: Cardiac arrest after intravenous metoclopramide - a case of five repeated injections of metoclopramide causing five episodes of cardiac arrest
ARTICLE SOURCE: Acta Anaesthesiol Scand (Denmark), Aug 2002, 46(7) p908-10
AUTHOR(S): Bentsen G; Stubhaug A
AUTHOR'S ADDRESS: Department of Anaesthesiology, Rikshospitalet, Oslo, Norway.
PUBLICATION TYPEJournal Article
ABSTRACT: We describe a patient where intravenous injection of metoclopramide was immediately followed by asystole repeatedly. The patient received metoclopramide 10 mg i.v. five times during 48 h. After interviewing the attending nurses and reviewing the written documentation, it is clear that every administration of metoclopramide was immediately (within s) followed by asystole. The asystole lasted 15-30 s on four occasions, on one occasion it lasted 2 min. The patient received atropine 0.5-1 mg and chest compressions, before sinus rhythm again took over. We interpret this as episodes of cardiac arrest caused by metoclopramide. The rapid injection via the central venous route and the concomitant tapering of dopamine infusion might have contributed in precipitating the adverse drug reaction.
MB. *Wow*

ARTICLE TITLE: Survey of epidural analgesia management in general intensive care units in England
ARTICLE SOURCE: Acta Anaesthesiol Scand (Denmark), Aug 2002, 46(7) p799-805
AUTHOR(S): Low JH
AUTHOR'S ADDRESS: Intensive Care Unit, Nuffield Department of Anesthetics. The John Radcliffe Hospital, Oxford, UK.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Practice varied considerably with little consensus. Although all the respondents use epidural analgesia in critically ill patients, the indications and contraindications to epidural analgesia remain controversial, and further research is required to help define the role of epidural analgesia in this high-risk group.
MB. Fashion based medicine.

ARTICLE TITLE: Epidural blood patch for management of postdural puncture headache in adolescents
ARTICLE SOURCE: Acta Anaesthesiol Scand (Denmark), Aug 2002, 46(7) p794-8
AUTHOR(S): Ylonen P; Kokki H
AUTHOR'S ADDRESS: Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Finland.
PUBLICATION TYPE: Journal Article
RESULTS: Forty-two epidural blood patchs (EBP) were performed after 40 spinal punctures (SP) on 37 patients (24 girls, 13 boys). The success rate of the first injection was 37 out of 40 EBP (93%), and the second injection was effective in both patients with recurred PDPH. CONCLUSION: Epidural blood patch seems to be an effective and safe procedure in adolescents for treating severe and persistent postdural puncture headache (PDPH).

ARTICLE TITLE: Improved long-lasting postoperative analgesia, recovery function and patient satisfaction after inguinal hernia repair with inguinal field block compared with general anesthesia
ARTICLE SOURCE: Acta Anaesthesiol Scand (Denmark), Jul 2002, 46(6) p674-8
AUTHOR(S): Aasbo V; Thuen A; Raeder J
AUTHOR'S ADDRESS: Department of Anesthesia, Ostfold Hospital, Fredrikstad, Norway. vi-aasbo@online.no.
PUBLICATION TYPE: Journal Article
CONCLUSION: Preoperative inguinal field block for hernia repair provides benefits for patients in terms of faster recovery, less pain, better mobilization and higher satisfaction throughout the whole first postoperative week.

ARTICLE TITLE: Small-volume resuscitation: from experimental evidence to clinical routine. Advantages and disadvantages of hypertonic solutions
ARTICLE SOURCE: Acta Anaesthesiol Scand (Denmark), Jul 2002, 46(6) p625-38
AUTHOR(S): Kreimeier U; Messmer K
AUTHOR'S ADDRESS: Department of Anesthesiology and Institute for Surgical Research, Ludwig-Maximilian University Munich, Munich, Germany.
PUBLICATION TYPE: Journal Article. Review.
CONCLUSION: Small-volume resuscitation by means of hypertonic NaCl/colloid solutions stands for one of the most innovative concepts for primary resuscitation from trauma and shock established in the past decade. Today the spectrum of potential indications envolves not only prehospital trauma care, but also perioperative and intensive care therapy.
MB. This conclusion is not consistent with my impression of the literature.

ARTICLE TITLE: Beneficial effects of metoprolol on myocardial sympathetic function: Evidence from a randomized, placebo-controlled study in patients with congestive heart failure
ARTICLE SOURCE: Am Heart J (United States), Aug 2002, 144(2) pE3
AUTHOR(S): de Milliano PA; de Groot AC; Tijssen JG; van Eck-Smit BL; Van Zwieten PA; Lie KI
AUTHOR'S ADDRESS: Department of Cardiology, Ziekenhuis Hilversum, Hilversum, The Netherlands. pardemilliano@wxs.nl.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: This randomized, placebo-controlled study demonstrates that metoprolol has a presynaptic effect as measured by myocardial I-metaiodobenzylguanidine (MIBG) scintigraphy in both ischemic and nonischemic cardiomyopathy.

ARTICLE TITLE: An integrated approach to diagnosis and therapeutic management of patients with systolic heart failure in the Copenhagen metropolitan area
ARTICLE SOURCE: Am Heart J (United States), Aug 2002, 144(2) pE2
AUTHOR(S): Galatius S; Gustafsson F; Nielsen PH; Atar D; Hildebrandt PR
AUTHOR'S ADDRESS: Department of Cardiology, Frederiksberg University Hospital, Copenhagen, Denmark. galatius@dadlnet.dk.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Patients with systolic heart failure are not always optimally treated. The establishment of a heart failure clinic, which offers the combination of diagnosing and managing congestive heart failure, appears to be efficient both in
MB.This is not the first article I've noticed concluding that not all patients with 'cardiac failure' are now thought to be optimal therapy. This may be because of the virtual reversal of the management. Thus many patients presenting for surgery are probably not optimised. The slow initiation of the modern therapy means that IV beta blockers in the perioperative period will not always be optimal.

ARTICLE TITLE: Correlates and outcomes of preserved left ventricular systolic function among older adults hospitalized with heart failure
ARTICLE SOURCE: Am Heart J (United States), Aug 2002, 144(2) p365-72
AUTHOR(S): Ahmed A; Roseman JM; Duxbury AS; Allman RM; De Long JF
AUTHOR'S ADDRESS: Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala, USA. aahmed@uab.edu.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Among older adults hospitalized with heart failure (HF), preserved left ventricular systolic function (LVSF). was common among women and was associated with significantly higher morbidity and mortality rates, which were unaffected by treatment with angiotensin-converting enzyme (ACE) inhibitors.
MB. Strange.

ARTICLE TITLE: Cardiologists' discussions about sexuality with patients with chronic coronary artery disease
ARTICLE SOURCE: Am Heart J (United States), Aug 2002, 144(2) p239-42
AUTHOR(S): Bedell SE; Duperval M; Goldberg R
AUTHOR'S ADDRESS: Lown Cardiovascular Center, Brookline, Mass 02446, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Our study suggests that patients welcome the chance to talk with their cardiologist about sexual function. More attention should be given to this aspect of quality of life, especially for women with coronary disease.

ARTICLE TITLE: Quality of life improves with treatment in the Canadian Trial of Atrial Fibrillation.
ARTICLE SOURCE: Am Heart J (United States), Jun 2002, 143(6) p984-90
AUTHOR(S): Dorian P; Paquette M; Newman D; Green M; Connolly SJ; Talajic M; Roy D
AUTHOR'S ADDRESS: Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. dorianp@smh.toronto.on.ca.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSION: In patients with symptomatic atrial fibrillation (AF), quality of life (QOL) improves after treatment, independent of the specific drug used for treatment. This is especially true for patients in whom treatment prevents AF recurrence.

ARTICLE TITLE: Quality of life in patients with life-threatening arrhythmias: does choice of therapy make a difference
ARTICLE SOURCE: Am Heart J (United States), Aug 2002, 144(2) p208-11
AUTHOR(S): Exner DV
PUBLICATION TYPE: Editorial
MB. About the choice between implantable defibrillators & drugs.

ARTICLE TITLE: The past, present, and future of the implantable cardioverter defibrillator.
COMMENTS: Original Report In: Original Report In: RefSource:Am J Med. 2002 May; 112(7):577-9
ARTICLE SOURCE: Am J Med (United States), Jul 2002, 113(1) p82-4
AUTHOR(S): Kupersmith J
PUBLICATION TYPE Editorial

ARTICLE TITLE: Effects of exercise training in patients with heart failure: the Exercise Rehabilitation Trial (EXERT).
COMMENTS: Comment In: Comment In: RefSource:Am Heart J. 2002 Jul; 144(1):1-4/
ARTICLE SOURCE: Am Heart J (United States), Jul 2002, 144(1) p23-30
AUTHOR(S): McKelvie RS; Teo KK; Roberts R; McCartney N; Humen D; Montague T; Hendrican K; Yusuf S
AUTHOR'S ADDRESS: Division of Cardiology and Preventive Cardiology and Therapeutic Program, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada. mckelrob@hhsc.on.ca.
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
CONCLUSIONS: Exercise training improves peak oxygen uptake and strength during supervised training. Over the final 9 months of the study, there was little further improvement, suggesting that some supervision is required for these patients. There were no adverse effects on cardiac function or clinical events.
MB. Wouldn't any improvement plateau after a while?

ARTICLE TITLE: Selective L-type, T-type, and nonspecific calcium-channel blockers for stable angina pectoris.
COMMENTS: Comment On: Comment On: RefSource:Am Heart J. 2002 Jul; 144(1):60-7
ARTICLE SOURCE: Am Heart J (United States), Jul 2002, 144(1) p8-10
AUTHOR(S): Thadani U
PUBLICATION TYPE: Comment; Editorial
MB. As calcium channel blockers increase mortality this editorial suggests that it would not be a good idea to use this stuff for angina.

ARTICLE TITLE: Effects of hospital volume on long-term outcomes after percutaneous transluminal coronary angioplasty after acute myocardial infarction.
ARTICLE SOURCE: Am Heart J (United States), Jul 2002, 144(1) p144-50
AUTHOR(S): Doucet M; Eisenberg M; Joseph L; Pilote L
AUTHOR'S ADDRESS: Division of Clinical Epidemiology, The Montreal General Hospital Research Institute, The McGill University Health Center, Montreal, Quebec, Canada.
PUBLICATION TYPEJournal Article; Multicenter Study
CONCLUSION: Overall adverse event rates at 6 months after percutaneous transluminal coronary angioplasty PTCA do not differ between hospital volume groups. The higher rate of CABG in low-volume hospitals and the higher rate of repeat PTCA in high-volume hospitals may represent different physician preferences for the treatment of failed PTCA rather than higher complication rates.
MB. It would be hard to set up a valid controlled trial to establish the relative benefits.

ARTICLE TITLE: Is more better?
COMMENTS: Comment On: Comment On: RefSource:Am Heart J. 2002 May; 143(5):833-40
ARTICLE SOURCE: Am Heart J (United States), May 2002, 143(5) p745-7
AUTHOR(S): Nash IS; Jollis JG
PUBLICATION TYPE: Comment; Editorial
MB. About the numbers of angioplasties & outcomes. There is a problem if angioplasties are in competition with CABGs or medical treatment when conflicts of interest will occur.

ARTICLE TITLE: Identification of patients at high risk for death and cardiac ischemic events after hospital discharge.
ARTICLE SOURCE: Am Heart J (United States), Jun 2002, 143(6) p966-70
AUTHOR(S): Sabatine MS; McCabe CH; Morrow DA; Giugliano RP; de Lemos JA; Cohen M; Antman EM; Braunwald E
AUTHOR'S ADDRESS: TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Mass 02115, USA. msabatine@partners.org.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: More than one fourth of the major cardiac events that will occur in the first 6 weeks occur after discharge from the hospital. Stratification at presentation on the basis of the Thrombolysis In Myocardial Infarction (TIMI) risk score for unstable angina (UA) / non-ST-elevation myocardial infarction (NSTEMI can be used to identify patients at high risk for these events. Among patients at high-risk, acute-phase treatment with enoxaparin significantly reduces the risk of major cardiac events after leaving the hospital.

ARTICLE TITLE: Two vessels or not two vessels? That is the question.
COMMENTS: Comment On: Comment On: RefSource:Am Heart J. 2002 Jun; 143(6):1017-26
ARTICLE SOURCE: Am Heart J (United States), Jun 2002, 143(6) p948-9
AUTHOR(S): Kahn JK; O'Neill WW
PUBLICATION TYPE: Comment; Editorial
MB.Whether to stent a limited number of vessels at each sitting.

ARTICLE TITLE: Recertification: nobody asked me!.
ARTICLE SOURCE: Am Heart J (United States), Jun 2002, 143(6) p946-7
AUTHOR(S): Klodas E
PUBLICATION TYPE: Editorial
MB. An apology for avoiding recertification.

ARTICLE TITLE: Recertification: mandatory or voluntary? Teaching old docs new tricks.
COMMENTS: Comment On: Comment On: RefSource:Am Heart J. 2002 Jun; 143(6):943-4
ARTICLE SOURCE: Am Heart J (United States), Jun 2002, 143(6) p945
AUTHOR(S): Skorton DJ; Mulhern KM
PUBLICATION TYPE: Comment; Editorial
MB. A justification for recertification.

ARTICLE TITLE: An interventional cardiologist: a cardiologist who intervenes.
COMMENTS: Comment In: Comment In: RefSource:Am Heart J. 2002 Jun; 143(6):945
ARTICLE SOURCE: Am Heart J (United States), Jun 2002, 143(6) p943-4
AUTHOR(S): Brush JE
PUBLICATION TYPE:

ARTICLE TITLE: Cardiogenic shock complicating acute myocardial infarction in elderly patients: does admission to a tertiary center improve survival?
ARTICLE SOURCE: Am Heart J (United States), May 2002, 143(5) p768-76
AUTHOR(S): Berger AK; Radford MJ; Krumholz HM
AUTHOR'S ADDRESS: Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, and Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, CT 06520-8025, USA.
PUBLICATION TYPE: Journal Article
ABSTRACT: BACKGROUND: The role of early revascularization among patients with acute myocardial infarction complicated by cardiogenic shock remains controversial. RESULTS: Of the 601 patients with cardiogenic shock, 287 (47.8%) were admitted to hospitals without revascularization services and 314 (52.2%) were admitted to hospitals with coronary angioplasty and coronary artery bypass surgery facilities. After adjustment for demographic, clinical, hospital, and treatment strategies, the presence of onsite revascularization services was not associated with a significantly lower 30-day (odds ratio 0.83, 95% CI 0.47, 1.45) or 1-year mortality (odds ratio 0.91, 95% CI 0.49, 1.72).
MB. Retrospective & not randomised but not enthusiastic.

ARTICLE TITLE: Long-term outcome and the use of revascularization in patients with heart failure, suspected ischemic heart disease, and large reversible myocardial perfusion defects.
ARTICLE SOURCE: Am Heart J (United States), May 2002, 143(5) p904-9
AUTHOR(S): Miller WL; Tointon SK; Hodge DO; Nelson SM; Rodeheffer RJ; Gibbons RJ
AUTHOR'S ADDRESS: Division of Cardiovascular Diseases and Internal Medicine and the Section of Biostatistics, Mayo Clinic, Rochester, MN 55905, USA. miller.wayne@mayo.edu.
PUBLICATION TYPE: Journal Article
ABSTRACT: BACKGROUND: The potential role of coronary revascularization in the management of patients with congestive heart failure and suspected ischemic heart disease remains to be defined. Myocardial perfusion imaging can identify patients with ischemic heart disease as the etiology for left ventricular dysfunction who might benefit from revascularization. METHODS: We retrospectively identified heart failure patients with suspected ischemic heart disease who had large reversible perfusion defects to determine their long-term outcome and rate of revascularization. The study group consisted of 77 patients with congestive heart failure, left ventricular ejection fraction <45%, and suspected ischemic heart disease who underwent myocardial perfusion imaging during the period of January 1, 1991, to December 31, 1997, and had large reversible perfusion defects. RESULTS: The 5-year mortality rate was 57.6%. The revascularization rate was only 13% for 5 years of follow-up. The number of patients undergoing revascularization was too small to assess its impact on outcome. CONCLUSION: These results indicate a high 5-year mortality rate and a low utilization of coronary revascularization in patients with heart failure and large reversible perfusion defects. The low rate of revascularization reflects at least in part the absence of the generalizability of the existing literature to the optimal means of treating patients with heart failure and myocardial ischemia and points to the need for a randomized clinical trial.
MB. The original big studies (1980s) indicated reduced mortality only in those with defective myocardia. I wonder why they have not taken that attitude.

ARTICLE TITLE: Enoxaparin in acute coronary syndromes: evidence for superiority over placebo or untreated control.
ARTICLE SOURCE: Am Heart J (United States), May 2002, 143(5) p748-52
AUTHOR(S): Massel D; Cruickshank MK
AUTHOR'S ADDRESS: Department of Medicine, London Health Sciences Centre, University of Western Ontario. dmassel@lhsc.on.ca.
PUBLICATION TYPE: Journal Article; Meta-Analysis

ARTICLE TITLE: Addressing antibiotic resistance.
ARTICLE SOURCE: Am J Med (United States), Jul 8 2002, 113 Suppl 1A p29S-34S
AUTHOR(S): Gupta K
AUTHOR'S ADDRESS: Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington School of Medicine, Seattle 98195, USA.
PUBLICATION TYPE: Status: Completed
Journal Article; Review; Review, Tutorial
As a result, these trends have necessitated a change in the management approach to community-acquired urinary tract infections (UTIs). The use of trimethoprim-sulfamethoxazole (TMP-SMX) as a first-line agent for empiric therapy of uncomplicated cystitis is only appropriate in areas where TMP-SMX resistance prevalence is <10% to 20%. In areas where resistance to TMP-SMX exceeds this rate, alternative agents need to be considered.

ARTICLE TITLE: What's the story--how patients make medical decisions.
COMMENTS: Comment On: Comment On: RefSource:Am J Med. 2002 Jul; 113(1):22-9
ARTICLE SOURCE: Am J Med (United States), Jul 2002, 113(1) p73-4
AUTHOR(S): Hallenbeck JL
PUBLICATION TYPE: Comment; Editorial
MB. About patients constructing theories for themselves using as an example hormone replacement.

ARTICLE TITLE: Effect of patient education on self-management skills and health status in patients with asthma: a randomized trial.
ARTICLE SOURCE: Am J Med (United States), Jul 2002, 113(1) p7-14
AUTHOR(S): Perneger TV; Sudre P; Muntner P; Uldry C; Courteheuse C; Naef AF; Jacquemet S; Nicod L; Rochat T; Assal JP
AUTHOR'S ADDRESS: Institute of Social and Preventive Medicine, Geneva University Hospitals, University of Geneva, 24 Micheli-du-Crest, CH-1211 Geneva, Switzerland. thomas.perneger@hcuge.ch.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
The education program did not enhance patients' health and functional status, despite improving a few self-management skills. These results underscore the need for controlled evaluations of education programs.
MB. My late father as an old-time pharmacist said that diabetics were much better than asthmatics in making sure they had adequate supplies of their medication.

ARTICLE TITLE: Truth telling and patient autonomy: the patient's point of view.
ARTICLE SOURCE: Am J Med (United States), Jul 2002, 113(1) p66-9
AUTHOR(S): Schattner A; Tal M
AUTHOR'S ADDRESS: Department of Medicine, Kaplan Medical Center, Hadassah Medical Center, Rehovot 76100, Israel. amiMD@clalit.org.il.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: The effects of inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review of randomized placebo-controlled trials.
ARTICLE SOURCE: Am J Med (United States), Jul 2002, 113(1) p59-65
AUTHOR(S): Alsaeedi A; Sin DD; McAlister FA
AUTHOR'S ADDRESS: Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta T6G 2B7, Canada.
PUBLICATION TYPE: Journal Article; Review; Review, Academic
No effects were seen on all-cause mortality (RR = 0.84; 95% CI: 0.60 to 1.18) in the five trials that measured this outcome.This systematic review demonstrates a beneficial effect of inhaled corticosteroids in reducing rates of chronic obstructive pulmonary disease (COPD) exacerbation. Further research is required to define the long-term effects of these medications and the benefit/risk ratio for patients with COPD.

ARTICLE TITLE: Let's give nurses a fair shake
ARTICLE SOURCE: Am J Surg (United States), Aug 2002, 184(2) p87
AUTHOR(S): Pennell R
AUTHOR'S ADDRESS: On behalf of the Advocacy Council of the Southwestern Surgical Congress; Suite 7011B, 621 South New Ballas Rd., 63141, St. Louis, MO, USA.
PUBLICATION TYPE: Journal Article
ABSTRACT: America faces an impending national crisis as fewer nurses are being trained and fewer are remaining active in the nursing profession. By improving our attitudes toward nurses and by offering educational incentives, we may still be able to provide enough nurses to avoid a catastrophic nursing shortfall.
MB. I would not be hopeful.

ARTICLE TITLE: A preliminary measurement of the surgical personality
ARTICLE SOURCE: Am J Surg (United States), Aug 2002, 184(2) p121
AUTHOR(S): McGreevy J; Wiebe D
AUTHOR'S ADDRESS: Department of Surgery, University of Utah, 50 North Medical Dr., 84132, Salt Lake City, UT, USA.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Meta-analysis of laparoscopic inguinal hernia trials favors open hernia repair with preperitoneal mesh prosthesis.
ARTICLE SOURCE: Am J Surg (United States), Jul 2002, 184(1) p6-10
AUTHOR(S): Voyles CR; Hamilton BJ; Johnson WD; Kano N
AUTHOR'S ADDRESS: Department of Surgery, University of Mississippi School of Medicine, Jackson, MS, USA. crvoyles@yahoo.com.
PUBLICATION TYPE: Journal Article; Meta-Analysis
ABSTRACT: BACKGROUND: This meta-analysis was performed to determine the degree to which improvements in open hernia repair (OHR) in the last decade have altered the relative benefit of laparoscopic hernia repair (LHR). METHODS: Twenty-seven comparative trials including 4,688 randomized patients were evaluated. RESULTS: Within the control OHR, patients with routine mesh repair returned to work earlier than a sutured repair (16.4 versus 27.3 days, P = 0.010). During the study period, the increased use of mesh in OHR (3 of 12 initially versus 9 of 15 subsequent studies) was associated with an earlier return to work (25.9 to 16.8 days, P = 0.017); there was no significant improvement with corresponding LHR. CONCLUSIONS: Although LHR was associated with an earlier return to work compared with conventional sutured OHR, more recent mesh OHRs provide equivalent outcomes but at lower costs and potentially less severe complications, supporting an open technique using preperitoneal mesh prostheses as the optimal hernia repair.
MB. I've waited 4 years, sent 2 brothers for it & waited for that surgeon to have done more than 100. I would have had an LHR by the time this issue was published but the operating list was cancelled through lack of nursing staff.
BTW, It should be endoscopic extraperitoneal HR (EEHR).

ARTICLE TITLE: Mild hypothermia does not increase bacterial proliferation on implanted vascular grafts.
ARTICLE SOURCE: Am J Surg (United States), Jul 2002, 184(1) p37-40
AUTHOR(S): Alfonsi P; Coggia M; Leflon-Guibout V; Sessler DI; Goeau-Brissonniere O; Chauvin M
AUTHOR'S ADDRESS: Department of Anesthesiology, Hopital Ambroise Pare AP-HP, and Rene Descartes University, 9 Avenue Charles de Gaulle, Boulogne-Billancourt, 92100, France. pascal.alfonsi@apr.ap-hop-paris.fr.
PUBLICATION TYPE: Evaluation Studies; Journal Article
CONCLUSIONS: Mild perioperative hypothermia does not increase proliferation of S epidermidis on aortic vascular grafts.
MB. In dogs.

ARTICLE TITLE: Do anaesthetists need to wear surgical masks in the operating theatre?
ARTICLE SOURCE: Anaesth Intensive Care (Australia), Aug 2002, 30(4) p530-1; discussion 531-2
AUTHOR(S): Joffe AM; Lafferty S
PUBLICATION TYPE: Letter

ARTICLE TITLE: Surgical masks in the operating theatre: they are really necessary in cardiovascular procedures
ARTICLE SOURCE: Anaesth Intensive Care (Australia), Jun 2002, 30(3) p386-7
AUTHOR(S): Cikirikcioglu M; Duran E
PUBLICATION TYPE: Letter
MB. Skinner et al (Anaesthesia and Intensive Care, 200;29:331-8) had referred, in support of eliminating masks, to the practice in the hospital of these letter writters, and this was not entirely correct. See the original, letters & another letter Anaes Intens Care 2002; 30:386-7.

ARTICLE TITLE: Awareness under TIVA: a doctor's personal experience
ARTICLE SOURCE: Anaesth Intensive Care (Australia), Aug 2002, 30(4) p505-6
AUTHOR(S): Rowan KJ
PUBLICATION TYPE Journal Article
MB. A horror story. TIVA with pump failure.

ARTICLE TITLE: Anaphylaxis to Haemaccel and cross reactivity to Gelofusin
ARTICLE SOURCE: Anaesth Intensive Care (Australia), Aug 2002, 30(4) p481-3
AUTHOR(S): Russell WJ; Fenwick DG
AUTHOR'S ADDRESS: Department of Anaesthesia and Intensive Care, Royal Adelaide Hospital, South Australia.
PUBLICATION TYPE: Journal Article
MB.It appears that patients who are known to be allergic to Haemaccel are probably allergic also to Gelofusin.

ARTICLE TITLE: Risk factors for epistaxis during nasotracheal intubation
ARTICLE SOURCE: Anaesth Intensive Care (Australia), Aug 2002, 30(4) p449-52
AUTHOR(S): Sim WS; Chung IS; Chin JU; Park YS; Cha KJ; Lee SC; Kim YC
AUTHOR'S ADDRESS: Department of Anesthesia, Sung Kyun Kwan University School of Medicine, Seoul, Korea.
PUBLICATION TYPE: Journal Article
Strategies to ensure smooth transit of the tube through the nasal passageways are essential to reduce the incidence of epistaxis.
MB. They mention in the discussion the use of vaso-constrictors in the nose but but don't appear to have used them in their study.

ARTICLE TITLE: Washing of gloved hands in antiseptic solution prior to central venous line insertion reduces contamination
ARTICLE SOURCE: Anaesth Intensive Care (Australia), Jun 2002, 30(3) p338-40
AUTHOR(S): Kocent H; Corke C; Alajeel A; Graves S
AUTHOR'S ADDRESS: Intensive Care Unit, The Geelong Hospital, Barwon Heath, Victoria.
PUBLICATION TYPE: Journal Article
ABSTRACT: Glove contamination at the time a central venous catheter is handled is highly undesirable and likely to increase the risk of subsequent line infection. This study was designed to determine how frequently gloves become contaminated during central venous line insertion and to demonstrate the value of glove decontamination immediately prior to handling of the central venous catheter During twenty routine internal jugular catheter insertions the sterility of the operator's gloved fingertips (just prior to handling the intravenous catheter) was assessed by touching the fingertips onto blood agar plates. The gloved hands were then rinsed in chlorhexidine/alcohol and after drying were placed onto a further plate. Contamination was detected in 55% of the prewash plates but in none of the postwash plates. Procedures performed by less experienced resident staff had a higher contamination rate despite there being no evident breach of sterile technique. It is likely that glove contamination results from the persistance of bacteria within the deeper layers of the skin, despite surface disinfection. These bacteria may be released by manipulation of the skin when identifying landmarks. This hypothesis was supported by a subsequent observation that gloves were more highly contaminated after firm touching of the skin rather than light touching. Glove contamination during central line insertion is frequent. Catheter contamination rates could be reduced (without risk or additional cost) by rinsing gloved hands in a solution of chlorhexidine (0.5%) in alcohol (70%) prior to handling the catheter.
MB. This may be a good reason for using a stick on plastic drape then palpation could occur without contaminating the fingers. There should be surgical literature to support the common use of steridrapes. We make a practice of changing gloves immediately before 'floating ' pulmonary artery catheters during multiple line insertions for liver trasnplants.

ARTICLE TITLE: A Comparison of the Laryngeal Mask Airway ProSeal(TM) and the Laryngeal Tube Airway in Paralyzed Anesthetized Adult Patients Undergoing Pressure-Controlled Ventilation
ARTICLE SOURCE: Anesth Analg (United States), Sep 2002, 95(3) p770-6
AUTHOR(S): Brimacombe J; Keller C; Brimacombe L
AUTHOR'S ADDRESS: Department of Anaesthesia and Intensive Care, Cairns Base Hospital, The Esplanade, Cairns, Australia.
PUBLICATION TYPE: Journal Article
IMPLICATIONS: The laryngeal mask airway ProSeal(TM) offers advantages over the laryngeal tube airway in most technical aspects of airway management in paralyzed patients undergoing pressure-controlled ventilation.

ARTICLE TITLE: Bispectral index in patients with target-controlled or manually-controlled infusion of propofol
ARTICLE SOURCE: Anesth Analg (United States), Sep 2002, 95(3) p639-44
AUTHOR(S): Lehmann A; Boldt J; Thaler E; Piper S; Weisse U
AUTHOR'S ADDRESS: Departments of Anesthesiology and Intensive Care Medicine and Cardiac Surgery, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany.
PUBLICATION TYPE: Journal Article
IMPLICATIONS: In this prospective, randomized study, bispectral index (BIS), hemodynamics, time to extubation, and costs of target-controlled infusion (TCI) and manually-controlled infusion of propofol were compared. TCI increased the amount of propofol used. BIS failed to predict the adequacy of anesthesia for the next painful stimulus.

ARTICLE TITLE: The practice of thoracic epidural analgesia: a survey of academic medical centers in the United States.
ARTICLE SOURCE: Anesth Analg (United States), Aug 2002, 95(2) p472-5
AUTHOR(S): Minzter BH; Johnson RF; Grimm BJ
AUTHOR'S ADDRESS: Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee 37232, USA. beth.mintzer@mcmail.vanderbilt.edu.
PUBLICATION TYPE: Journal Article
MB. A survey

ARTICLE TITLE: Temperature control and recovery of bowel function after laparoscopic or laparotomic colorectal surgery in patients receiving combined epidural/general anesthesia and postoperative epidural analgesia.
ARTICLE SOURCE: Anesth Analg (United States), Aug 2002, 95(2) p467-71, table of contents
AUTHOR(S): Danelli G; Berti M; Perotti V; Albertin A; Baccari P; Deni F; Fanelli G; Casati A
AUTHOR'S ADDRESS: Department of Anesthesiology, Vita-Salute University of Milano, IRCCS H.S. Raffaele, Milano, Italy.
PUBLICATION TYPEClinical Trial; Journal Article; Randomized Controlled Trial
IMPLICATIONS: This prospective, randomized, controlled study demonstrates that laparoscopic colorectal surgery results in less postoperative pain and earlier recovery of bowel function than conventional laparotomy but does not reduce the risk for perioperative hypothermia. Accordingly, active warming must be provided to patients also during laparoscopic procedures.
MB. They don't mention whether they used active warming on either group or what if any other measures were used to maintain temperature.

ARTICLE TITLE: A comparison of three anesthetic techniques in patients undergoing craniotomy for supratentorial intracranial surgery.
ARTICLE SOURCE: Anesth Analg (United States), Aug 2002, 95(2) p430-5, table of contents
AUTHOR(S): Talke P; Caldwell JE; Brown R; Dodson B; Howley J; Richardson CA
AUTHOR'S ADDRESS: Department of Anesthesia and Perioperative Medicine, University of California, San Francisco, California 94143, USA. talkep@anesthesia.ucsf.edu.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
We evaluated 3 anesthetic techniques in 60 patients undergoing elective surgery for supratentorial mass lesions. Patients were randomly assigned to three anesthesia study groups: propofol infusion, isoflurane inhalation, and these two techniques combined. In the combination group, once the dura was closed, isoflurane was discontinued and propofol infusion simultaneously started<snip>. IMPLICATIONS: We evaluated three anesthetic techniques with and without propofol in patients undergoing elective surgery for supratentorial mass lesions by using a prospective, randomized clinical study design and found that the three anesthetics did not differ in intra- or postoperative hemodynamic stability or early postoperative recovery variables.
MB. The only difference they found was in costs. I would have expected that. I hope those following the fashions studied will be encouraged to review their beliefs/practices. I don't hold out much hope.

ARTICLE TITLE: Thoracic epidural catheter placement via the caudal approach in infants by using electrocardiographic guidance.
ARTICLE SOURCE: Anesth Analg (United States), Aug 2002, 95(2) p326-30, table of contents
AUTHOR(S): Tsui BC; Seal R; Koller J
AUTHOR'S ADDRESS: Department of Anesthesiology and Pain Medicine, University of Alberta Hospitals, Walter Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada. btsui@ualberta.ca.
PUBLICATION TYPE: Status: Completed
Clinical Trial; Journal Article
MB. You'd have to be keen. They seemed to be just doing 'routine' abdominal & thoracic operations

ARTICLE TITLE: Intraoperative washing of long-stored packed red blood cells by using an autotransfusion device prevents hyperkalemia.
ARTICLE SOURCE: Anesth Analg (United States), Aug 2002, 95(2) p324-5, table of contents
AUTHOR(S): Knichwitz G; Zahl M; Van Aken H; Semjonow A; Booke M
AUTHOR'S ADDRESS: Department of Anesthesiology, University of Munster, Munster, Germany.
PUBLICATION TYPE: Journal Article
ABSTRACT: IMPLICATIONS:Long-stored packed red blood cells (PRBCs) have a large potassium load. In patients with end-stage renal failure, the transfusion of such PRBCs may cause a critical increase in plasma potassium levels. Washing PRBCs with an autotransfusion device allows for a marked decrease in potassium load, thus preventing hyperkalemia.
MB. They claim to be the first to suggest this in 2000. We have been doing it routinely in liver transplants since 1988. I heard about it in San Francisco. I applied it after we'd had 3 hyperkalaemic arrests in our first 30 liver transplants.

ARTICLE TITLE: Falsely increased bispectral index values in a series of patients undergoing cardiac surgery using forced-air-warming therapy of the head.
ARTICLE SOURCE: Anesth Analg (United States), Aug 2002, 95(2) p322-3, table of contents
AUTHOR(S): Hemmerling TM; Fortier JD
AUTHOR'S ADDRESS: Department of Anesthesiology, Centre Hospitalier de l'Universite de Montreal, Hotel-Dieu, Universite de Montreal, Quebec, Canada. thomashemmerling@hotmail.com.
PUBLICATION TYPE: Journal Article
ABSTRACT: IMPLICATIONS: Falsely increased bispectral index (BIS) values of >70 occur during forced-warm-air therapy in patients undergoing cardiac surgery. When forced-warm-air therapy for the head is used (as in ultra-fast-tracking cardiac patients), BIS interpretation needs careful examination. Falsely increased BIS values can easily be recognized when the warm-air flow is stopped. Within 2-3 min, BIS returns to a much lower, "true" value.
MB. How long more will this thing last.

ARTICLE TITLE: Early postoperative respiratory acidosis after large intravascular volume infusion of lactated ringer's solution during major spine surgery.
ARTICLE SOURCE: Anesth Analg (United States), Aug 2002, 95(2) p294-8, table of contents
AUTHOR(S): Takil A; Eti Z; Irmak P; Yilmaz Gogus F
AUTHOR'S ADDRESS: Department of Anesthesiology, Medical Faculty of Marmara University, Istanbul, Turkey. takilarzu@hotmail.com.
PUBLICATION TYPE: Clinical Trial; Journal Article
IMPLICATIONS: The infusion of large-volume lactated Ringer's solution does not cause hyperchloremic metabolic acidosis as does 0.9% saline during major surgery, but leads to postoperative mild hyponatremia and respiratory acidosis.
MB. There are some other explanations for the acid -base & CO2 observations. The metabolic acidosis in the saline group might have stimulated the respirations which was depressed for pharmacological reasons in the LR group.

ARTICLE TITLE: Aprotinin versus placebo in major orthopedic surgery: a randomized, double-blinded, dose-ranging study.
ARTICLE SOURCE: Anesth Analg (United States), Aug 2002, 95(2) p287-93, table of contents
AUTHOR(S): Samama CM; Langeron O; Rosencher N; Capdevila X; Rouche P; Pegoix M; Berniere J; Coriat P
AUTHOR'S ADDRESS: Departement d'Anesthesie-Reanimation, Centre Hospitalo-Universitaire (CHU) Avicenne, Bobigny, France. cmsamama@invivo.edu.
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
.Fifty-eight patients were randomized into three groups: Large-Dose Aprotinin (4 M kallikrein inactivator unit [KIU] bolus before surgery followed by a continuous infusion of 1 M KIU/h until the end of surgery), Small-Dose Aprotinin (2 M KIU bolus plus 0.5 M KIU/h), and Placebo. IMPLICATIONS: Large doses of aprotinin decrease blood loss and transfusion amount in major orthopedic surgery.
MB. They chose to study only patients in whom large blood loss would be expected - revision spine or hip surgery, trauma surgery, cancer surgery, or surgery for sepsis with an expected blood loss of >2000 ml.

ARTICLE TITLE: Awareness and recall in outpatient anesthesia.
ARTICLE SOURCE: Anesth Analg (United States), Jul 2002, 95(1) p72-7, table of contents
AUTHOR(S): Wennervirta J; Ranta SO; Hynynen M
AUTHOR'S ADDRESS: Department of Anesthesia and Intensive Care Medicine, Children's Hospital, Helsinki University Central Hospital, Stenbackinkatu 11, FIN-00290 Helsinki, Finland. johanna.wennervirta@hus.fi.
PUBLICATION TYPE: Clinical Trial; Journal Article
IMPLICATIONS: Rapid recovery from general anesthesia is a crucial element of outpatient surgery. However, this practice may predispose a patient to receive less anesthetic, with increased risk for awareness and recall. We have shown that outpatients undergoing an operation using general anesthesia are not at increased risk for awareness compared with inpatients.
MB. I don't think they can make such a universal statement.

ARTICLE TITLE: The effect on lung mechanics in anesthetized children with rapacuronium: a comparative study with mivacurium.
ARTICLE SOURCE: Anesth Analg (United States), Jul 2002, 95(1) p56-61, table of contents
AUTHOR(S): Fine GF; Motoyama EK; Brandom BW; Fertal KM; Mutich R; Davis PJ
AUTHOR'S ADDRESS: Department of Anesthesiology, Division of Pulmonology, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA. finegf@anes.upmc.edu.
PUBLICATION TYPE: Clinical Trial; Journal Article
IMPLICATIONS: Pulmonary function tests in the present study showed that rapacuronium consistently causes severe bronchoconstriction, confirming clinical case reports of bronchospasm. The bronchoconstriction is reversible with albuterol. Mivacurium also causes very mild subclinical bronchoconstriction.
MB. I marvel that this stuff ever got off the ground. At least it's gone forever now. We missed out. It seems that every candidate to replace sux makes things worse. The search effort might be better directed somewhere else.

ARTICLE TITLE: Fentanyl attenuates the hemodynamic response to endotracheal intubation more than the response to laryngoscopy.
ARTICLE SOURCE: Anesth Analg (United States), Jul 2002, 95(1) p233-7, table of contents
AUTHOR(S): Adachi YU; Satomoto M; Higuchi H; Watanabe K
AUTHOR'S ADDRESS: Department of Anesthesiology, Medical Clinic of Kumagaya Base, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, Japan 359-8513. grd1117@gr.ndmc.ac.jp.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
IMPLICATIONS: We assessed the effectiveness of avoiding laryngoscopy for orotracheal intubation. There was no significant difference in the hemodynamic responses to orotracheal intubation by fiberscopy and laryngoscopy without fentanyl pretreatment, whereas 2 microg/kg fentanyl significantly reduced the hemodynamic responses in the group intubated by fiberscopy. Pretreatment of fentanyl and fiberoptic intubation might be recommended for avoiding hyperdynamic responses.
MB. Why not get the patient anaesthetised as they would be for surgery before intubating by whatever method. Trying to control the pulse rate independently is pretty silly.

ARTICLE TITLE: Anesthesiologists and acute perioperative stress: a cohort study.
ARTICLE SOURCE: Anesth Analg (United States), Jul 2002, 95(1) p177-83, table of contents
AUTHOR(S): Kain ZN; Chan KM; Katz JD; Nigam A; Fleisher L; Dolev J; Rosenfeld LE
AUTHOR'S ADDRESS: Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. kain@biomed.med.yale.edu.
PUBLICATION TYPE: Clinical Trial; Journal Article
IMPLICATIONS: Anesthesiologists experience minor psychologic stress while involved in the anesthetic process.
MB. They would hardly be likely to find any major disturbances or stress as the anaesthetists concerned would have given up or even committed suicide.

ARTICLE TITLE: A new highly reliable instrument for the assessment of pre- and postoperative gynecological pain.
ARTICLE SOURCE: Anesth Analg (United States), Jul 2002, 95(1) p151-7, table of contents
AUTHOR(S): Stener-Victorin E; Kowalski J; Lundeberg T
AUTHOR'S ADDRESS: Department of Obstetrics and Gynecology, Goteborg University, SE-413 45 Goteborg, Sweden. elisabet.stener-victorin@medstud.gu.se.
PUBLICATION TYPE: Clinical Trial; Evaluation Studies; Journal Article; Randomized Controlled Trial
IMPLICATIONS: We evaluated a new instrument for pain assessment. Our results show that this method is highly reliable, is well tolerated by the patients, is reported to be easy to use, and may be useful when evaluating acute pre- and postoperative pain.
MB. It sound about a silly as VAS. There can be no reliable method of measuring pain. Pain is transcendental.

ARTICLE TITLE: Can succinylcholine be used safely in hyperkalemic patients?
ARTICLE SOURCE: Anesth Analg (United States), Jul 2002, 95(1) p119-22, table of contents
AUTHOR(S): Schow AJ; Lubarsky DA; Olson RP; Gan TJ
AUTHOR'S ADDRESS: Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.
PUBLICATION TYPE: Journal Article
IMPLICATIONS: In a review of more than 40,000 general anesthetics in which succinylcholine was given at induction, 38 patients had a preoperative potassium of 5.6 mEq/L or greater. All patients survived the anesthetic with no dysrhythmias or other major morbidity documented. Succinylcholine may be appropriate and safe for use in certain patients with moderate hyperkalemia.

ARTICLE TITLE: Summaries for patients. Screening for colorectal cancer: recommendations from the United States Preventive Services Task Force.
COMMENTS: Original Report In: Original Report In: RefSource:Ann Intern Med. 2002 Jul 16; 137(2):129-31/PMID:12118971; Original Report In: Original Report In: RefSource:Ann Intern Med. 2002 Jul 16; 137(2):132-41/PMID:12118972; Original Report In: Original Report In: RefSource:Ann Intern Med. 2002 Jul 16; 137(2):96-104/PMID:12118964
ARTICLE SOURCE: Ann Intern Med (United States), Jul 16 2002, 137(2) pI38
PUBLICATION TYPE: Journal Article; Patient Education Handout

ARTICLE TITLE: Summaries for patients. A decision aid for recognizing and treating heart attacks quickly.
COMMENTS: Original Report In: Original Report In: RefSource:Ann Intern Med. 2002 Jul 16; 137(2):87-95
ARTICLE SOURCE: Ann Intern Med (United States), Jul 16 2002, 137(2) pI24
PUBLICATION TYPE: Journal Article; Patient Education Handout

ARTICLE TITLE: Reflections on medical journals: has progress made them better?
ARTICLE SOURCE: Ann Intern Med (United States), Jul 2 2002, 137(1) p46-8
AUTHOR(S): Kassirer JP
PUBLICATION TYPE: Editorial
MB. Some questioning of current accepted 'finding out' strategies. Worth reading full text. (BTW, before being editor of NEJM, Kassirer wrote some very insightful papers on the kidneys, electrolytes & acid base balance. See my acid base stuff. http://www.usyd.edu.au/anaes/lectures/acidbase_mjb/acidbase.html

ARTICLE TITLE: Truth survival in clinical research: an evidence-based requiem?
ARTICLE SOURCE: Ann Intern Med (United States), Jun 18 2002, 136(12) p888-95
AUTHOR(S): Poynard T; Munteanu M; Ratziu V; Benhamou Y; Di Martino V; Taieb J; Opolon P
AUTHOR'S ADDRESS: Service d'Hepato-Gastroenterologie, Groupe Hospitalier Pitie-Salpetriere, 47-83 Boulevard de l'Hopital, 75651 Paris Cedex 13, France. tpoynard@teaser.fr.
PUBLICATION TYPE: Journal Article
ABSTRACT: PURPOSE: Factors associated with the survival of truth of clinical conclusions in the medical literature are unknown. STUDY SELECTION: Original articles and meta-analyses published from 1945 to 1999 about cirrhosis or hepatitis in adults. DATA SYNTHESIS: In 2000, 285 of 474 conclusions (60%) were still considered to be true, 91 (19%) were considered to be obsolete, and 98 (21%) were considered to be false. The half-life of truth was 45 year. CONCLUSIONS: Contrary to the authors' hypothesis, conclusions based on recognized, good methodology had no clear survival advantage. To better convince clinicians of the long-term utility of evidence-based medicine, better prognostic factors should be developed.
MB. It appears that the evidence-only-based craze was invented in only in 1991.(See Evidence-based Medicine. Guyatt Ann Intern Med 1991;114:A-16, Evidence-based Medicine. A new approach to teaching the prctice of medicine. JAMA, Nov 4 1992,268; 2420-6.) Evidence/observations are only part of reality. Thought/ideas are only part of reality. The combination of both approach closer to reality than either evidence or ideas alone. One can see why heresies were so loathed in stable societies. At least we don't burn heretics at the stake any more. With the present problems with idiological diversity one might begin to wonder.

ARTICLE TITLE: Learning from our mistakes: quality grand rounds, a new case-based series on medical errors and patient safety.
COMMENTS: Comment On: Comment On: RefSource:Ann Intern Med. 2002 Jun 4; 136(11):826-33
ARTICLE SOURCE: Ann Intern Med (United States), Jun 4 2002, 136(11) p850-2
AUTHOR(S): Wachter RM; Shojania KG; Saint S; Markowitz AJ; Smith M
PUBLICATION TYPE: Comment; Editorial
MB. They 're going to publish a series of these. The following is the first. Read the full text.

ARTICLE TITLE: The wrong patient.
COMMENTS: Comment In: Comment In: RefSource:Ann Intern Med. 2002 Jun 4; 136(11):850-2
ARTICLE SOURCE: Ann Intern Med (United States), Jun 4 2002, 136(11) p826-33
AUTHOR(S): Chassin MR; Becher EC
AUTHOR'S ADDRESS: Department of Health Policy, Mount Sinai School of Medicine, Box 1077, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA. mark.chassin@mssm.edu.
PUBLICATION TYPE: Journal Article
ABSTRACT: Among all types of medical errors, cases in which the wrong patient undergoes an invasive procedure are sufficiently distressing to warrant special attention. Nevertheless, institutions underreport such procedures, and the medical literature contains no discussions about them. This article examines the case of a patient who was mistakenly taken for another patient's invasive electrophysiology procedure. After reviewing the case and the results of the institution's "root-cause analysis," the discussants discovered at least 17 distinct errors, no single one of which could have caused this adverse event by itself. The discussants illustrate how these specific "active" errors interacted with a few underlying "latent conditions" (system weaknesses) to cause harm. The most remediable of these were absent or misused protocols for patient identification and informed consent, systematically faulty exchange of information among caregivers, and poorly functioning teams.
MB. They found 17 errors. There could have been more. That number just means that no one gives a f---. It is similar to the Canturbury (hospital in Sydney, Australia) event where phenol was injected into 23 sets of bile ducts. I've heard they found 37 errors in that affair.

ARTICLE TITLE: Randomized study of the benefits of preoperative corticosteroid administration on the postoperative morbidity and cytokine response in patients undergoing surgery for esophageal cancer
ARTICLE SOURCE: Ann Surg (United States), Aug 2002, 236(2) p184-90
AUTHOR(S): Sato N; Koeda K; Ikeda K; Kimura Y; Aoki K; Iwaya T; Akiyama Y; Ishida K; Saito K; Endo S
AUTHOR'S ADDRESS: Departments of Surgery I and Critical Care and Emergency Medicine, Iwate Medical University, School of Medicine, Morioka, Japan.
PUBLICATION TYPE: Journal Article
RESULTS: The percentage of patients in the MP group who had one or more organ system failures was 33%, significantly lower than the corresponding percentage of 61% in the control group. The surgery-related complication rate and long-term survival rate were similar in the two groupsCONCLUSIONS: The results suggest that prophylactic administration of corticosteroids is associated with a decrease in postoperative morbidity in patients undergoing invasive surgery. The laboratory data suggest that corticosteroids may attenuate surgical stress-induced inflammatory responses both directly by suppressing the release of proinflammatory cytokines and via inducing IL-10 synthesis.
MB. It seems that in fact there was no real benefit in the long term & minor disadvantages at best/worst.

ARTICLE TITLE: Donor health assessment after living-donor liver transplantation.
ARTICLE SOURCE: Ann Surg (United States), Jul 2002, 236(1) p120-6
AUTHOR(S): Diaz GC; Renz JF; Mudge C; Roberts JP; Ascher NL; Emond JC; Rosenthal P
AUTHOR'S ADDRESS: Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Donors overwhelmingly endorsed living donation regardless of recipient outcome or the occurrence of a complication. Eighty-nine percent advocated "increased" application of living donation beyond "emergency situations," and no donor responded that living donation should be abandoned or that he or she felt "forced" to donate.
MB. Its more like donor endorsment than donor health. What about the N.Y. journalist live liver donor who died?

ARTICLE TITLE: Medication errors observed in 36 health care facilities
ARTICLE SOURCE: Arch Intern Med (United States), Sep 9 2002, 162(16) p1897-903
AUTHOR(S): Barker KN; Flynn EA; Pepper GA; Bates DW; Mikeal RL
AUTHOR'S ADDRESS: Center for Research on Pharmacy Operations and Designs, School of Pharmacy, Auburn University, 128 Miller Hall, Auburn, AL 36849-5506. barkekn@auburn.edu.
PUBLICATION TYPE: Status: In-Process
Journal Article
CONCLUSIONS: Medication errors were common (nearly 1 of every 5 doses in the typical hospital and skilled nursing facility). The percentage of errors rated potentially harmful was 7%, or more than 40 per day in a typical 300-patient facility. The problem of defective medication administration systems, although varied, is widespread.
MB. This is hopeless. Some new system which does not involve humans in day to day services needs to be developed.

ARTICLE TITLE: Unforeseen consequences of terrorism: medically unexplained symptoms in a time of fear
ARTICLE SOURCE: Arch Intern Med (United States), Sep 9 2002, 162(16) p1809-13
AUTHOR(S): Hassett AL; Sigal LH
AUTHOR'S ADDRESS: Departments of Medicine, Family Medicine, and Psychiatry, Division of Rheumatology and Connective Tissue Research, UMDNJ-Robert Wood Johnson Medical School, One Robert Wood Johnson Place, MEB-484, New Brunswick, NJ 08903. a.hassett@umdnj.edu.
PUBLICATION TYPE: Editorial

ARTICLE TITLE: Religious involvement and cigarette smoking in young adults: the CARDIA study (Coronary Artery Risk Development in Young Adults)study.
ARTICLE SOURCE: Arch Intern Med (United States), Jul 22 2002, 162(14) p1604-10
AUTHOR(S): Whooley MA; Boyd AL; Gardin JM; Williams DR
AUTHOR'S ADDRESS: Department of Veterans Affairs Medical Center and Department of Medicine, University of California, San Fancisco, 94121, USA. whooley@itsa.ucsf.edu.
PUBLICATION TYPE: Journal Article; Multicenter Study
CONCLUSIONS: Young adults who attend religious services have lower rates of current and subsequent cigarette smoking. The potential health benefits associated with religious involvement deserve further study.
MB. I don't think religious activity is a very reliable way of stopping smoking.

ARTICLE TITLE: Preoperative or postoperative start of prophylaxis for venous thromboembolism with low-molecular-weight heparin in elective hip surgery?
ARTICLE SOURCE: Arch Intern Med (United States), Jul 8 2002, 162(13) p1451-6
AUTHOR(S): Strebel N; Prins M; Agnelli G; Buller HR
AUTHOR'S ADDRESS: Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.
PUBLICATION TYPE: Journal Article; Meta-Analysis; Review; Review, Tutorial

ARTICLE TITLE: Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study.
ARTICLE SOURCE: Arch Intern Med (United States), Jun 10 2002, 162(11) p1245-8
AUTHOR(S): Heit JA; O'Fallon WM; Petterson TM; Lohse CM; Silverstein MD; Mohr DN; Melton LJ
AUTHOR'S ADDRESS: Hematology Research, Stabile 660, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Factors associated with institutionalization independently account for more than 50% of all cases of venous thromboembolism in the community. Greater emphasis should be placed on prophylaxis for hospitalized medical patients. Other recognized risk factors account for about 25% of all cases of venous thromboembolism, while the remaining 25% of cases are idiopathic

ARTICLE TITLE: Sildenafil for male erectile dysfunction: a systematic review and meta-analysis.
ARTICLE SOURCE: Arch Intern Med (United States), Jun 24 2002, 162(12) p1349-60
AUTHOR(S): Fink HA; MacDonald R; Rutks IR; Nelson DB; Wilt TJ
AUTHOR'S ADDRESS: Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center, 1 Veterans Dr, PO Box 11G, Minneapolis, MN 55417, USA. howard.fink@med.va.gov.
PUBLICATION TYPE: Journal Article; Meta-Analysis; Review; Review, Academic
MB. Everything you wanted to know about VIAGRA but were too afraid to ask.
.

ARTICLE TITLE: Systematic review and meta-analysis of interventions for postoperative fatigue
ARTICLE SOURCE: Br J Surg (England), Aug 2002, 89(8) p971-84
AUTHOR(S): Rubin GJ; Hotopf M
AUTHOR'S ADDRESS: Section of General Hospital Psychiatry, Division of Psychological Medicine, Guy's, King's and St Thomas's School of Medicine and the Institute of Psychiatry, King's College London, London, UK.
PUBLICATION TYPE: Journal Article
CONCLUSION: While the results demonstrate that improved analgesia can attenuate immediate postoperative fatigue in most patient groups, further research is needed to determine whether the efficacy of human growth hormone and glucocorticoids extends beyond abdominal surgery. The paucity of research into cognitive-behavioural, sleep and activity-based interventions also needs to be addressed.

ARTICLE TITLE: Patient volumes and complications in thyroid surgery.
ARTICLE SOURCE: Br J Surg (England), Jul 2002, 89(7) p821-3
AUTHOR(S): McHenry CR
AUTHOR'S ADDRESS: Department of Surgery, MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, H-918, Cleveland, Ohio 44109-1998, USA. cmchenry@metrohealth.org.
PUBLICATION TYPE: Journal Article
MB. Encouraging specialisation in thyroid surgery. All surgery should be specialised.

ARTICLE TITLE: Concepts and correlations relevant to general anaesthesia
ARTICLE SOURCE: Br J Anaesth (England), Jul 2002, 89(1) p3-16
AUTHOR(S): Urban BW; Bleckwenn M
AUTHOR'S ADDRESS: Klinik fur Anasthesiologie und spezielle Intensivmedizin, Universitatsklinikum Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn, Germany.
PUBLICATION TYPE: Journal Article
MB. The whole July issue is on the Molecular and Basic Mechanisms of Anaesthesia. This article starts by pointing out that GA has become almost compleletely safe with no theory of anaesthetic actions and asks rhetorically if we thus need to know how. I would think 'no' for those practicing anaesthesia.

ARTICLE TITLE: Current assessment of targets and theories of anaesthesia
ARTICLE SOURCE: Br J Anaesth (England), Jul 2002, 89(1) p167-83
AUTHOR(S): Urban BW
AUTHOR'S ADDRESS: Klinik fur Anasthesiologie und spezielle Intensivmedizin, Universitatsklinikum Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn, Germany.
PUBLICATION TYPE: Journal Article
MB. This is the last in the series. In the legend of one diagram it says 'The networks that are responsible for translating molecular effects into clinically observable effects are still unknown'. This must be the 3 ^rd such issue of the some anaesthetic journal since I've been around. As we still have no idea of the mechanism of consciousness it is not surprising that we can't connect the chemical structures of anaesthetic drugs to the entity of consciouness which is as much a mystery now as its been from ancient times.

ARTICLE TITLE: ProSeal versus the Classic laryngeal mask airway for positive pressure ventilation during laparoscopic cholecystectomy
ARTICLE SOURCE: Br J Anaesth (England), Jun 2002, 88(6) p824-7
AUTHOR(S): Lu PP; Brimacombe J; Yang C; Shyr M
AUTHOR'S ADDRESS: Department of Anesthesia, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kuei-Shan Hsiang, 333 Taoyuan Hsien, Taiwan.
PUBLICATION TYPE: Journal Article
CONCLUSION: The PLMA is a more effective ventilatory device for laparoscopic cholecystectomy than the LMA. We do not recommend the use of the LMA for laparoscopic cholecystectomy.
MB. Neither should be used for that operation.

ARTICLE TITLE: Assessment of liver function: its application to outcome from liver transplantation
ARTICLE SOURCE: Br J Anaesth (England), Jun 2002, 88(6) p757-60
AUTHOR(S): Sear JW
PUBLICATION TYPE: Editorial

ARTICLE TITLE: Rocuronium plasma concentrations during three phases of liver transplantation: relationship with early postoperative graft liver function
ARTICLE SOURCE: Br J Anaesth (England), Jun 2002, 88(6) p764-70
AUTHOR(S): Gao L; Ramzan I; Baker B
AUTHOR'S ADDRESS: Department of Anaesthesia (D06), University of Sydney, Sydney, NSW 2006, Australia.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Comparison of changes in plasma rocuronium concentration during the neohepatic phase with early postoperative liver function tests suggests the potential use of rocuronium as a pharmacokinetic probe for predicting liver function during liver transplantation. Further study of rocuronium's potential as an intraoperative pharmacodynamic probe of liver function by measuring neuromuscular paralysis is suggested.
MB. One of ours.

ARTICLE TITLE: Somebody else's nervous system
ARTICLE SOURCE: Br J Anaesth (England), Jun 2002, 88(6) p760-3
AUTHOR(S): Fettes PD; Wildsmith JA
PUBLICATION TYPE: Editorial
MB. About permenant damage from anaesthetists attacking the spine.

ARTICLE TITLE: Gate control theory of pain stands the test of time
ARTICLE SOURCE: Br J Anaesth (England), Jun 2002, 88(6) p755-7
AUTHOR(S): Dickenson AH
PUBLICATION TYPE: Editorial
MB. An enthusiastic updating. The theory has never been of value to me.

ARTICLE TITLE: Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design.
ARTICLE SOURCE: Br J Anaesth (England), May 2002, 88(5) p659-68
AUTHOR(S): Apfel CC; Kranke P; Katz MH; Goepfert C; Papenfuss T; Rauch S; Heineck R; Greim CA; Roewer N
AUTHOR'S ADDRESS: Department of Anaesthesiology, Julius-Maximilians-University of Wuerzburg, Germany.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSION: Volatile anaesthetics were the leading cause of early postoperative vomiting. The pro-emetic effect was larger than other risk factors. In patients at high risk for PONV, it would therefore make better sense to avoid inhalational anaesthesia rather than simply to add an antiemetic, which may still be needed to prevent or treat delayed vomiting.

ARTICLE TITLE: Respiratory response to skin incision during anaesthesia with infusions of propofol and alfentanil.
ARTICLE SOURCE: Br J Anaesth (England), May 2002, 88(5) p649-52
AUTHOR(S): Dockery MP; Drummond GB
AUTHOR'S ADDRESS: University Department of Anaesthesia, Critical Care, and Pain Medicine, Royal Infirmary of Edinburgh, UK.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: During opioid anaesthesia, the mechanism of ventilatory increase after stimulation involves changes in both drive and timing of breathing. This pattern of response does not resemble the changes seen during anaesthesia with potent volatile agents.
MB. Look at the full article if you are interested.

ARTICLE TITLE: EEG signal processing in anaesthesia. Use of a neural network technique for monitoring depth of anaesthesia.
ARTICLE SOURCE: Br J Anaesth (England), May 2002, 88(5) p644-8
AUTHOR(S): Ortolani O; Conti A; Di Filippo A; Adembri C; Moraldi E; Evangelisti A; Maggini M; Roberts SJ
AUTHOR'S ADDRESS: Dipartimento Area Critica Medico Chirurgica, Universita di Firenze, Italy.
PUBLICATION TYPE: Clinical Trial; Journal Article
CONCLUSION: We have developed a neural network model, which evaluates 13 processed EEG parameters to produce an index of anaesthesia depth, which correlates very well with the Bispectral Index (BIS) during total i.v. anaesthesia with propofol.
MB. I can't imagine that any is better than any other. Consciousness & awareness cannot be detected by empirical observations. The patient has to convince another human.

ARTICLE TITLE: The proseal laryngeal mask: results of a descriptive trial with experience of 300 cases.
ARTICLE SOURCE: Br J Anaesth (England), Apr 2002, 88(4) p534-9
AUTHOR(S): Evans NR; Gardner SV; James MF; King JA; Roux P; Bennett P; Nattrass R; Llewellyn R; Visu D
AUTHOR'S ADDRESS: Department of Anaesthesia, University of Cape Town, Groote Schuur Hospital, Observatory, South Africa.
PUBLICATION TYPE Evaluation Studies; Journal Article
CONCLUSIONS: The ProSeal laryngeal mask airway (PLMA) is a reliable airway management device that can give an effective glottic seal in paralysed and non-paralysed patients. The device allows the easy passage of a gastric tube, causes a minimal haemodynamic response to insertion, and an acceptable incidence of sore throat.

ARTICLE TITLE: Can a clinically useful aortic pressure wave be derived from a radial pressure wave?
ARTICLE SOURCE: Br J Anaesth (England), Apr 2002, 88(4) p481-8
AUTHOR(S): Soderstrom S; Nyberg G; O'Rourke MF; Sellgren J; Ponten J
AUTHOR'S ADDRESS: Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Goteborg, Sweden.
PUBLICATION TYPE: Journal Article; Validation Studies
CONCLUSIONS: By deriving an aortic waveform from the radial pulse, monitoring of left ventricular afterload can improve without more invasive means.
MB. They suggest that we should be using the derivable information contained in a radial pressure trace. I recall that this was a hope in the 1960s. Most of the hope seemed to disappear into artifacts.

ARTICLE TITLE: Haemodilution enhances coagulation.
COMMENTS: Comment On: Comment On: RefSource:Br J Anaesth. 2002 Apr; 88(4):475-80/PMID:12066721
ARTICLE SOURCE: Br J Anaesth (England), Apr 2002, 88(4) p470-2
AUTHOR(S): Ruttmann TG
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Heparin resistance.
ARTICLE SOURCE: Br J Anaesth (England), Apr 2002, 88(4) p467-9
AUTHOR(S): Anderson JA; Saenko EL
PUBLICATION TYPE: Editorial

ARTICLE TITLE: 'Ventilating in recovery' - the way forward: intensive therapy or postoperative critical care?
COMMENTS: Comment On: Comment On: RefSource:Br J Anaesth. 2002 Apr; 88(4):577-9
ARTICLE SOURCE: Br J Anaesth (England), Apr 2002, 88(4) p473-4
AUTHOR(S): Jones AG; Harper SJ
PUBLICATION TYPE: Comment; Editorial
MB. Comment on lack of enough ICU beds.

ARTICLE TITLE: IV magnesium sulfate in the treatment of acute severe asthma: a multicenter randomized controlled trial ARTICLE SOURCE: Chest (United States), Aug 2002, 122(2) p489-97
AUTHOR(S): Silverman RA; Osborn H; Runge J; Gallagher EJ; Chiang W; Feldman J; Gaeta T; Freeman K; Levin B; Mancherje N; Scharf S
AUTHOR'S ADDRESS: Department of Emergency Medicine, Long Island Jewish Medical Center, New Hyde Park, NY 11042, USA. aresilv@aol.com; Collective Name: Acute Asthma/Magnesium Study Group.
PUBLICATION TYPE: Journal Article
CONCLUSION: Administration of 2 g of IV magnesium sulfate improves pulmonary function when used as an adjunct to standard therapy in patients with very severe, acute asthma.

ARTICLE TITLE: Magnesium treatment for asthma : where do we stand?
ARTICLE SOURCE: Chest (United States), Aug 2002, 122(2) p396-8
AUTHOR(S): Noppen M
AUTHOR'S ADDRESS: Dr. Noppen is Associate Professor and Head of the Interventional Endoscopy Clinic, Respiratory Division, University Hospital AZ-VUB, and Faculty of Medicine, Free University of Brussels (VUB).
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Why do physicians not follow evidence-based guidelines for preventing ventilator-associated pneumonia?(*) : a survey based on the opinions of an international panel of intensivists
ARTICLE SOURCE: Chest (United States), Aug 2002, 122(2) p656-61
AUTHOR(S): Rello J; Lorente C; Bodi M; Diaz E; Ricart M; Kollef MH
AUTHOR'S ADDRESS: Critical Care Department (Drs. Rello, Lorente, Bodi, and Diaz, and Ms. Ricart), University Hospital Joan XXIII, University Rovira and Virgili, Tarragona, Spain.
PUBLICATION TYPE: Status: In-Process
Journal Article
CONCLUSION: We conclude that nonadherence to evidence-based guidelines (EBGs) for preventing ventilator-associated pneumonia (VAP was common and largely uninfluenced by the degree of evidence. A rational approach toward improving VAP guideline adherence should take into account the heterogeneous factors that influence physician adherence to them

ARTICLE TITLE: Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia.
ARTICLE SOURCE: Chest (United States), Jul 2002, 122(1) p262-8
AUTHOR(S): Iregui M; Ward S; Sherman G; Fraser VJ; Kollef MH
AUTHOR'S ADDRESS: Pulmonary and Critical Care Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
PUBLICATION TYPE: Journal Article
CONCLUSION: These data suggest that patients classified as receiving initially delayed appropriate antibiotic treatment (IDAAT) are at greater risk for hospital mortality. Clinicians should avoid delaying the administration of appropriate antibiotic treatment to patients with ventilator-associated pneumonia (VAP) in order to minimize their risk of mortality.

ARTICLE TITLE: Causes of prolonged mechanical ventilation (PMV ) after coronary artery bypass surgery.
ARTICLE SOURCE: Chest (United States), Jul 2002, 122(1) p245-52
AUTHOR(S): Yende S; Wunderink R
AUTHOR'S ADDRESS: Physician Research Network, Methodist Healthcare University Hospital, Memphis, TN, USA. yende@juno.com.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Continuous vs intermittent beta-agonists in the treatment of acute adult asthma: a systematic review with meta-analysis.
ARTICLE SOURCE: Chest (United States), Jul 2002, 122(1) p160-5
AUTHOR(S): Rodrigo GJ; Rodrigo C
AUTHOR'S ADDRESS: Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay. gurodrig@adinet.com.uy.
PUBLICATION TYPE: Journal Article; Meta-Analysis; Review; Review, Academic

ARTICLE TITLE: Obstructive sleep apnea: asleep in our consciousness no more.
COMMENTS: Comment On: Comment On: RefSource:Chest. 2002 Jun; 121(6):1741-7
ARTICLE SOURCE: Chest (United States), Jun 2002, 121(6) p1729-30
AUTHOR(S): Littner M; Alessi C
PUBLICATION TYPE: Comment; Editorial

ARTICLE TITLE: Four-step local anesthesia and sedation for thoracoscopic diagnosis and management of pleural diseases.
ARTICLE SOURCE: Chest (United States), Jun 2002, 121(6) p2032-5
AUTHOR(S): Migliore M; Giuliano R; Aziz T; Saad RA; Sgalambro F
AUTHOR'S ADDRESS: Section of General Thoracic Surgery, Department of Surgery, University of Catania, Catania, Italy. mmiglior@mbox.unict.it.
PUBLICATION TYPE Journal Article
ABSTRACT: STUDY OBJECTIVES: Most thoracic surgeons perform thoracoscopy under general anesthesia using a double-lumen endotracheal tube. We describe our own technique for performing thoracoscopy under local anesthesia and sedation. DESIGN, SETTING, PATIENTS: Forty-five patients underwent the procedure under local anesthesia and sedation (mean age, 64 years; age range, 40 to 92 years). <snip> Premedication was comprised of droperidol, 5 mg, and atropine, 0.5 mg, administered 20 min before the scheduled operating room time. Sedation was maintained by diazepam injection, 3 mg. Four-step local anesthesia in the planned intercostal space using 10 mL of ropivacaine, 7.5 mg/mL, was performed.
MB. Look at full article if interested.

ARTICLE TITLE: Pulmonary artery catheter: does the problem lie in the users?
ARTICLE SOURCE: Chest (United States), Jun 2002, 121(6) p2009-15
AUTHOR(S): Squara P; Bennett D; Perret C
AUTHOR'S ADDRESS: Reanimation polyvalente, Hopital Victor Dupouy, Argenteuil, France. squarap@worldnet.fr.
PUBLICATION TYPE: Journal Article
ABSTRACT: The aims of this study were to look for the variability in the treatment of circulatory shock and to assess the extent to which this variability was reduced by pulmonary artery catheterization (PAC). <snip> A total of 417 physicians took part in the discussions. Following the clinical presentation, only 38% of physicians suggested the same treatment as the experts, and 35% suggested potentially harmful treatments. Complete hemodynamic data from PAC significantly decreased the range of suggested treatments, improved agreement among physicians themselves as well as the agreement between physicians and experts, and decreased the number of potentially harmful propositions. However, whereas almost 80% of participants finally agreed on the treatment after one to three invasive hemodynamic sets of measurements, at least 10% persisted in suggesting potentially harmful treatments. PAC improved interphysician agreement, but our data suggest that yet greater agreement could be achieved by improving the theoretical training of practitioners.

ARTICLE TITLE: Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence.
ARTICLE SOURCE: Chest (United States), Jun 2002, 121(6) p2000-8
AUTHOR(S): Michard F; Teboul JL
AUTHOR'S ADDRESS: Medical ICU, CHU de Bicetre, Assistance Publique-Hopitaux de Paris, Le Kremlin-Bicetre, Universite Paris XI, France. f.michard@wanadoo.fr.
PUBLICATION TYPE: Journal Article; Review; Review, Academic
RESULTS: Twelve studies were analyzed in which the parameters tested were as follows: (1) static indicators of cardiac preload (right atrial pressure [RAP], pulmonary artery occlusion pressure [PAOP], right ventricular end-diastolic volume [RVEDV], and left ventricular end-diastolic area [LVEDA]); and (2) dynamic parameters (inspiratory decrease in RAP [Delta RAP], expiratory decrease in arterial systolic pressure [Delta down], respiratory changes in pulse pressure [Delta PP], and respiratory changes in aortic blood velocity [Delta Vpeak]). Before fluid infusion, RAP, PAOP, RVEDV, and LVEDA were not significantly lower in responders than in nonresponders in three of five studies, in seven of nine studies, in four of six studies, and in one of three studies, respectively. CONCLUSION: Dynamic parameters should be used preferentially to static parameters to predict fluid responsiveness in ICU patients.
MB. You need the parameter as well as 2 derivatives & 2 intergrals thereof.

ARTICLE TITLE: Variations in the measurement of weaning parameters: a survey of respiratory therapists.
COMMENTS: Comment In: Comment In: RefSource:Chest. 2002 Jun; 121(6):1738-40
ARTICLE SOURCE: Chest (United States), Jun 2002, 121(6) p1947-55
AUTHOR(S): Soo Hoo GW; Park L
AUTHOR'S ADDRESS: Pulmonary and Critical Care Section, West Los Angeles Veterans Affairs Medical Center and Department of Medicine, UCLA School of Medicine, Los Angeles, CA 90073, USA. Guy.Soohoo@med.va.gov.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: There is great variation among respiratory therapists when obtaining weaning parameters. This calls for further standardization of the measurement of weaning parameters.
MB. The whole concept of weaning is irrational except in muscular &/or neorological causes of respiratory failure.

ARTICLE TITLE: The anarchy of weaning techniques.
COMMENTS: Comment On: Comment On: RefSource:Chest. 2002 Jun; 121(6):1947-55
ARTICLE SOURCE: Chest (United States), Jun 2002, 121(6) p1738-40
AUTHOR(S): Manthous CA
PUBLICATION TYPE: Comment; Editorial
MB. Essentially this editorial means that the leaders amongst which Manthous numbers himself have got absolutely no idea. To imagine being able to encouraging the patient to do the work of breathing by withdrawing it as though it was a breast is stupid
A multicentre study in Spain some years ago showed that the quickest exit was a daily trial of stopping ventillation + clinical assessment.------3 times faster!!!!: A comparison of four methods of weaning patients from mechanical ventilation. Spanish Lung Failure Collaborative Group.: N Engl J Med (United States), Feb 9 1995, 332(6) p345-50 Esteban A; Frutos F; Tobin MJ; Alia I; Solsona JF; Valverdu I; Fernandez R; de la Cal MA; Benito S; Tomas R; et al Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Madrid, Spain. CONCLUSIONS. A once-daily trial of spontaneous breathing led to extubation about three times more quickly than intermittent mandatory ventilation and about twice as quickly as pressure-support ventilation. Multiple daily trials of spontaneous breathing were equally successful.
MB. I think they must need some new leaders

ARTICLE TITLE: Oral vs inhaled corticosteroids following emergency department discharge of patients with acute asthma.
COMMENTS: Comment On: Comment On: RefSource:Chest. 2002 Jun; 121(6):1798-805
ARTICLE SOURCE: Chest (United States), Jun 2002, 121(6) p1735-6
AUTHOR(S): Marik PE; Varon J
PUBLICATION TYPE: Comment; Editorial
MB. Look at this editorial. They obviously have not got very far in the last 30+ years but there are now some blind trials.

ARTICLE TITLE: Religious beliefs of patients and caregivers as a barrier to the pharmacologic control of cancer pain
ARTICLE SOURCE: Clin Pharmacol Ther (United States), Aug 2002, 72(2) p107-11
AUTHOR(S): Bosch F; Banos JE
AUTHOR'S ADDRESS: Department of Pharmacology, Therapeutics, and Toxicology, School of Medicine, Universitat Autonoma de Barcelona.
PUBLICATION TYPE: A review.

ARTICLE TITLE: Predictors of successful neuraxial block: a prospective study
ARTICLE SOURCE: Eur J Anaesthesiol (England), Jun 2002, 19(6) p447-51
AUTHOR(S): de Filho GR; Gomes HP; da Fonseca MH; Hoffman JC; Pederneiras SG; Garcia JH
AUTHOR'S ADDRESS: Hospital Governador Celso Ramos, Department of Anaesthesiology, Florianopolis, SC, Brazil. grof@th.com.br.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The successful location of the subarachnoid or the epidural space at the first attempt is influenced by the quality of patients' anatomical landmarks, the adequacy of patient positioning and the provider's level of experience.
MB. How surprising!!!

ARTICLE TITLE: Acid-base management - is it relevant for the study design of hypothermic neuroprotection?
ARTICLE SOURCE: Eur J Anaesthesiol (England), Jun 2002, 19(6) p389-94
AUTHOR(S): Frietsch T; Piepgras A; Krafft P; Schwab S; Kuschinsky W; Waschke KF
PUBLICATION TYPE: Editorial

ARTICLE TITLE: Delivery performance of commercial target-controlled infusion devices with Diprifusor module
ARTICLE SOURCE: Eur J Anaesthesiol (England), May 2002, 19(5) p357-60
AUTHOR(S): Schraag S; Flaschar J
AUTHOR'S ADDRESS: University of Ulm, Department of Anaesthesiology, Germany. stefanschraag@compuserve.com.
PUBLICATION TYPE: Journal Article
ABSTRACT: BACKGROUND AND OBJECTIVE: We measured the physical performance error of commercial syringe pumps incorporating the Diprifusor module to deliver propofol by target-controlled infusion in a laboratory experiment. CONCLUSIONS: Despite the differences between the pumps, which may be related to the synchronization of the hardware components, the absolute inaccuracies in the physical performance were low and presumably negligible from a clinical point of view.

ARTICLE TITLE: Comparison of the effects of remifentanil or fentanyl on anaesthetic induction characteristics of propofol, thiopental or etomidate
ARTICLE SOURCE: Eur J Anaesthesiol (England), May 2002, 19(5) p350-6
AUTHOR(S): Wilhelm W; Biedler A; Huppert A; Kreuer S; Bucheler O; Ziegenfuss T; Larsen R
AUTHOR'S ADDRESS: University of Saarland, Department of Anaesthesiology and Intensive Care Medicine, Homburg/Saar, Germany. wolfram.wilhelm@t-online.de.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: During anaesthetic induction, a remifentanil infusion of 0.5 microg kg(-1) min(-1) over 5 min is a suitable alternative to a 1.5 microg kg(-1) bolus dose of fentanyl: induction times are shorter with reduced amounts of propofol, thiopental or etomidate.
MB. It is not certain that they had equivalent doses of fentanyl & remifentanil. There was not much less CV effects with etomidate than with thiopentone.

ARTICLE TITLE: Use of sevoflurane during cardiopulmonary bypass decreases incidence of awareness
ARTICLE SOURCE: Eur J Anaesthesiol (England), Apr 2002, 19(4) p283-7
AUTHOR(S): Celebioglu B; Pamuk AG; Aypar U; Pasaoglu I
AUTHOR'S ADDRESS: Hacettepe University Medical School, Department of Anaesthesiology, Ankara, Turkey. bilgesel@superonline.com.tr.
PUBLICATION TYPE: Journal Article
METHODS: Fifty-nine patients of age >17 yr undergoing open-heart surgery with cardiopulmonary bypass were randomly assigned to two groups. In both groups, induction was with etomidate, dehydrobenzperidol and fentanyl; anaesthesia was maintained with sevoflurane, fentanyl and N20; vecuronium was used for muscular paralysis. Group 1 (30 patients) received dehydrobenzperidol and fentanyl during cardiopulmonary bypass; Group 2 (29 patients) received sevoflurane and fentanyl. Patients were given different auditory inputs during different phases of surgery. RESULTS: Five patients in the dehydrobenzperidol group gave a history of awareness (16.67%) as opposed to none in the sevoflurane group.

ARTICLE TITLE: End-of-life decisions in The Netherlands
ARTICLE SOURCE: Eur J Anaesthesiol (England), Mar 2002, 19(3) p161-5
AUTHOR(S): Booij LH
PUBLICATION TYPE: Editorial

ARTICLE TITLE: Invited editorial on "The alcohol breath test"
ARTICLE SOURCE: J Appl Physiol (United States), Aug 2002, 93(2) p405-6
AUTHOR(S): Hlastala MP
AUTHOR'S ADDRESS: Departments of Physiology and Biophysics and of Medicine, University of Washington, Seattle, Washington 98195-6522.
PUBLICATION TYPE: Journal Article
MB. Suggest some changes in breath test machines to make them fairer.

ARTICLE TITLE: Inhalation of warm and cold air does not influence brain stem or core temperature in normothermic humans
ARTICLE SOURCE: J Appl Physiol (United States), Jul 2002, 93(1) p65-9
AUTHOR(S): Mekjavic IB; Rogelj K; Radobuljac M; Eiken O
AUTHOR'S ADDRESS: Institute of Biomedical and Biomolecular Sciences, University of Portsmouth, Portsmouth, Hampshire PO1 2UP, United Kingdom.
PUBLICATION TYPE: Journal Article
We conclude that inhalation rewarming is not capable of warming the vital central neural structures adjacent to the naropharynx.
MB. How could they expect other than that for intracranial temperatures. They were actually measuring the infrared tympanic membrane temperature which are not very sensitive. The core temperature would not be changed in the 25 minutes they observed their patients

ARTICLE TITLE: Waging war on physical inactivity: using modern molecular ammunition against an ancient enemy
ARTICLE SOURCE: J Appl Physiol (United States), Jul 2002, 93(1) p3-30
AUTHOR(S): Booth FW; Chakravarthy MV; Gordon SE; Spangenburg EE
AUTHOR'S ADDRESS: Departments of Veterinary Biomedical Sciences and Physiology and the Dalton Cardiovascular Institute, University of Missouri, Columbia, Missouri 65211.
PUBLICATION TYPE: Journal Article
We hope that this information will provide readers with a starting point for developing additional strategies of their own in the ongoing war against inactivity-induced chronic health conditions.
MB. Hope is about all they have to offer.

ARTICLE TITLE: Beware Swan-Ganz complications. Perioperative management
ARTICLE SOURCE: J Cardiovasc Surg (Torino) (Italy), Aug 2002, 43(4) p467-70
AUTHOR(S): Asteri T; Tsagaropoulou I; Vasiliadis K; Fessatidis I; Papavasi-Liou E; Spyrou P
AUTHOR'S ADDRESS: Cardiac Anesthesia Department, G. Papanikolaou, Hospital, Exohi, Thessaloniki, Greece.
PUBLICATION TYPE: Journal Article
The first case is a carotid cannulation with an 8.5 Fr introducer sheath, in an attempt to insert a pulmonary catheter via the right internal jugular vein. Two weeks later, the patient was re-admitted to the hospital and when an arteriovenous fistulae (carotid artery-internal jugular vein) was diagnosed, he was treated surgically. The second case presents the rupture of the right atrium in the conjunction with the superior vena cava. This serious cardiac complication was developed during the floatation of the PAC and the lesion was repaired while the mitral valve replacement was in progress.

ARTICLE TITLE: Rapid inhalation induction with 7% sevoflurane combined with intravenous midazolam
ARTICLE SOURCE: J Clin Anesth (United States), Jun 2002, 14(4) p290-5
AUTHOR(S): Nishiyama T; Matsukawa T; Yokoyama T; Hanaoka K
AUTHOR'S ADDRESS: Surgical Center, Institute of Medical Science and the Department of Anesthesiology, University of Tokyo, Tokyo, Japan.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The addition of intravenous midazolam 0.1 mg/kg provides more stable hemodynamics, cardiac autonomic nervous system activity, and patient satisfaction in rapid inhalation induction with 7% sevoflurane.

ARTICLE TITLE: Postoperative nausea and vomiting: comparison of the effect of postoperative meperidine or morphine in gynecologic surgery patients
ARTICLE SOURCE: J Clin Anesth (United States), Jun 2002, 14(4) p262-6
AUTHOR(S): Ezri T; Lurie S; Stein A; Evron S; Geva D
AUTHOR'S ADDRESS: Department of Anesthesiology, Edith Wolfson Medical Center, Holon, Israel.
PUBLICATION TYPE: Journal Article
CONCLUSION: Our study demonstrates an advantage of the use of morphine rather than meperidine for pain control in the immediate postoperative period following gynecologic surgery.

ARTICLE TITLE: Postoperative nausea and vomiting after total intravenous anesthesia with propofol and remifentanil or alfentanil: how important is the opioid?
ARTICLE SOURCE: J Clin Anesth (United States), Jun 2002, 14(4) p275-8
AUTHOR(S): Dershwitz M; Michalowski P; Chang Y; Rosow CE; Conlay LA
AUTHOR'S ADDRESS: Department of Anesthesiology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA. mark.dershwitz@umassmed.edu.
PUBLICATION TYPE: Journal Article
CONCLUSION: When propofol-based TIVA is used for arthroscopic surgery, short-acting opioids do not significantly affect the risk of PONV.

ARTICLE TITLE: The effects of thiopental and generic and nongeneric propofol on respiratory resistance during anesthetic induction in patients with reactive airways
ARTICLE SOURCE: J Clin Anesth (United States), Jun 2002, 14(4) p257-61
AUTHOR(S): Arain SR; Navani A; Ebert TJ
AUTHOR'S ADDRESS: Department of Anesthesiology, V.A. Medical Center 112A, 5000 W. National Avenue, Milwaukee, WI 53295, USA.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: In contrast to earlier reports, this pilot study was unable to document a difference in the respiratory resistance in patients induced with thiopental or propofol. In addition, we were unable to demonstrate any different respiratory responses between generic propofol, containing sodium metabisulfite preservative, and nongeneric propofol.

ARTICLE TITLE: Intracerebral hemorrhage after spinal anesthesia
ARTICLE SOURCE: J Neurosurg Anesthesiol (United States), Jul 2002, 14(3) p234-7
AUTHOR(S): Sharma K
AUTHOR'S ADDRESS: Kamala Nehru Memorial Hospital, Allahabad, India.
PUBLICATION TYPE: Journal Article
ABSTRACT: SUMMARY: A rare case of intracerebral hematoma after spinal anesthesia is reported along with a review of the literature. The patient demonstrated a remarkable recovery after a timely diagnosis and surgical evacuation.

ARTICLE TITLE: Vasoactive modulators during and after craniotomy: relation to postoperative hypertension
ARTICLE SOURCE: J Neurosurg Anesthesiol (United States), Jul 2002, 14(3) p171-9
AUTHOR(S): Olsen KS; Pedersen CB; Madsen JB; Ravn LI; Schifter S
AUTHOR'S ADDRESS: Departments of Anesthesia and Clinical Physiology and Nuclear Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
PUBLICATION TYPE: Journal Article
The results suggest that in addition to an increased discharge of the sympathetic system, activation of the renin-angiotensin aldosterone system may also play an important role in the development of postoperative hypertension after craniotomy.

ARTICLE TITLE: Off-pump coronary bypass: Is it for everyone?
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Sep 2002, 124(3) p431-4
AUTHOR(S): Bonchek LI
AUTHOR'S ADDRESS: Lancaster General Hospital, Lancaster, Pa.
PUBLICATION TYPE: Journal Article
MB. He'd like more proof before everyone has to learn the method.

ARTICLE TITLE: Paraplegia after iatrogenic extrinsic spinal cord compression after descending thoracic aorta repair: Case report and literature review
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Aug 2002, 124(2) p407-10
AUTHOR(S): Biglioli P; Roberto M; Cannata A; Parolari A; Spirito R
AUTHOR'S ADDRESS: Department of Cardiovascular Surgery, Centro Cardiologico Fondazione Monzino, University of Milan, Milan, Italy.
PUBLICATION TYPE: Journal Article
MB. They stuffed a bit of cellulose gauze into the spinal canal.

ARTICLE TITLE: Off-pump coronary surgery: Effect on early mortality and stroke
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Aug 2002, 124(2) p313-20
AUTHOR(S): Cheng W; Denton TA; Fontana GP; Raissi S; Blanche C; Kass RM; Magliato KE; Mirocha J; Trento A
AUTHOR'S ADDRESS: Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif.
PUBLICATION TYPE: Status: In-Process
Journal Article
CONCLUSION: Off-pump coronary bypass did not reduce early mortality and morbidity. Early and late results should be compared in a prospective randomized study.

ARTICLE TITLE: Cardiopulmonary bypass: Evidence or experience based?
COMMENTS: Comment In: Comment In: RefSource:J Thorac Cardiovasc Surg. 2002 Jul; 124(1):11-3
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Jul 2002, 124(1) p20-7
AUTHOR(S): Bartels C; Gerdes A; Babin-Ebell J; Beyersdorf F; Boeken U; Doenst T; Feindt P; Heiermann M; Schlensak C; Sievers HH
AUTHOR'S ADDRESS: Clinic for Cardiac Surgery, Medical University of Luebeck, Germany; Collective Name: Working Group on Extracorporeal Circulation and Mechanical Ventricular Assist Devices of the German Society for Thoracic and Cardiovascular Surgery.
PUBLICATION TYPE: Journal Article
ABSTRACT: Evidence-based medicine is emerging as a new paradigm for medical practice. CONCLUSIONS: The scientific data concerning the effectiveness and safety of key principles of cardiopulmonary bypass are insufficient in both amount and quality of scientific evidence to serve as a basis for practical, evidence-based guidelines.
MB. It must be the world spirit causing the paradigm to emerge. They could not find enough good evidence in 33,000 articles to make up some guidelines.

ARTICLE TITLE: Minimally invasive coronary artery bypass grafting versus percutaneous transluminal coronary angioplasty with stenting in isolated high-grade stenosis of the proximal left anterior descending coronary artery: six months' angiographic and clinical follow-up of a prospective randomized study.
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Jul 2002, 124(1) p130-5
AUTHOR(S): Drenth DJ; Winter JB; Veeger NJ; Monnink SH; van Boven AJ; Grandjean JG; Mariani MA; Boonstra PW
AUTHOR'S ADDRESS: Thoraxcentre of the Groningen University Hospital, Groningen, The Netherlands.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: After 6 months, surgical intervention had a significantly better angiographic outcome than stenting in patients with an isolated high-grade stenosis of the proximal left anterior descending coronary artery. Clinical outcome did not significantly differ between treatments.

ARTICLE TITLE: Normothermia does not improve postoperative hemostasis nor does it reduce inflammatory activation in patients undergoing primary isolated coronary artery bypass.
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Jun 2002, 123(6) p1092-100
AUTHOR(S): Gaudino M; Zamparelli R; Andreotti F; Burzotta F; Iacoviello L; Glieca F; Benedett M; Maseri A; Schiavello R; Possati G
AUTHOR'S ADDRESS: Department of Cardiac Surgery, Catholic University, Rome, Italy. mgaudino@tiscalinet.it.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial

ARTICLE TITLE: Where are we going with computer-assisted or robotic cardiac surgery? A piece of the totally endoscopic coronary bypass puzzle.
COMMENTS: Comment On: Comment On: RefSource:J Thorac Cardiovasc Surg. 2002 Jun; 123(6):1125-31/PMID:12063459
ARTICLE SOURCE: J Thorac Cardiovasc Surg (United States), Jun 2002, 123(6) p1029-30
AUTHOR(S): Wolf RK
PUBLICATION TYPE: Comment; Editorial
MB. Maybe we can get rid of surgeons.

ARTICLE TITLE: Residents' prescription writing for nonpatients.
ARTICLE SOURCE: JAMA (United States), Jul 17 2002, 288(3) p381-5
AUTHOR(S): Aboff BM; Collier VU; Farber NJ; Ehrenthal DB
AUTHOR'S ADDRESS: Department of Medicine, Christiana Care Health System, 501 W 14th St, Wilmington, DE 19899, USA. baboff@christianacare.org.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: In a sample of community-based internal medicine and family practice residents, unsupervised prescription writing by residents for individuals who are not their patients is a common occurrence. Since residency training is a time when practice habits are established, it is important that all residents learn about the ethical, legal, and liability implications of writing prescriptions for nonpatients.

ARTICLE TITLE: Beta-blocker therapy and symptoms of depression, fatigue, and sexual dysfunction.
ARTICLE SOURCE: JAMA (United States), Jul 17 2002, 288(3) p351-7
AUTHOR(S): Ko DT; Hebert PR; Coffey CS; Sedrakyan A; Curtis JP; Krumholz HM
AUTHOR'S ADDRESS: Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT 06520-8025, USA.
PUBLICATION TYPE: Journal Article; Review; Review, Academic
CONCLUSION: The conventional wisdom that beta-blocker therapy is associated with substantial risks of depressive symptoms, fatigue, and sexual dysfunction is not supported by data from clinical trials. There is no significant increased risk of depressive symptoms and only small increased risks of fatigue and sexual dysfunction. The risks of these adverse effects should be put in the context of the documented benefits of these medications.
MB. What a relief.

ARTICLE TITLE: Can massive prevention efforts avert 29 million new cases of HIV by 2010?
ARTICLE SOURCE: JAMA (United States), Jul 17 2002, 288(3) p301-2
AUTHOR(S): Stephenson J
PUBLICATION TYPE: News
MB. It will be a big job.

ARTICLE TITLE: Responding to requests for physician-assisted suicide: "These are uncharted waters for both of us..."
ARTICLE SOURCE: JAMA (United States), Jul 3 2002, 288(1) p91-8
AUTHOR(S): Bascom PB; Tolle SW
AUTHOR'S ADDRESS: Division of General Internal Medicine and Geriatrics, L475, Center for Ethics in Health Care, Oregon Health & Science University, Portland, OR 97201, USA. bascomp@ohsu.edu.
PUBLICATION TYPE: Journal Article
Although physicians should remain mindful of their personal, moral, and legal concerns, these concerns should not override their willingness to explore what motivates a patient to make this request. When this approach is taken, suffering can be optimally alleviated and, in almost all cases, the patient's wishes can be met without physician-assisted suicide (PAS).

ARTICLE TITLE: JAMA patient page. Intensive care units.
ARTICLE SOURCE: JAMA (United States), Jun 26 2002, 287(24) p3326
AUTHOR(S): Stevens LM
PUBLICATION TYPE: Patient Education Handout

ARTICLE TITLE: From the Centers for Disease Control and Prevention. Occupational exposures to air contaminants at the World Trade Center disaster site--New York, September-October 2001.
ARTICLE SOURCE: JAMA (United States), Jun 26 2002, 287(24) p3201-2
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Noninvasive positive-pressure ventilation for postextubation respiratory distress: a randomized controlled trial.
ARTICLE SOURCE: JAMA (United States), Jun 26 2002, 287(24) p3238-44
AUTHOR(S): Keenan SP; Powers C; McCormack DG; Block G
AUTHOR'S ADDRESS: Department of Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada. Sean_Keenan@telus.net.
PUBLICATION TYPEClinical Trial; Journal Article; Randomized Controlled Trial
ABSTRACT: CONTEXT: Noninvasive positive-pressure ventilation (NPPV) has been demonstrated to be effective in preventing the need for endotracheal intubation in some patients who present with acute respiratory failure. It is also used for patients who develop acute respiratory distress after extubation, but there are no randomized controlled trials that address its effectiveness in this population. CONCLUSIONS: The addition of noninvasive positive-pressure ventilation (NPPV) to standard medical therapy does not improve outcome in heterogeneous groups of patients who develop respiratory distress during the first 48 hours after extubation.
MB. It seemed like a good idea to some intensivists.

ARTICLE TITLE: Vitamins for chronic disease prevention in adults: scientific review.
ARTICLE SOURCE: JAMA (United States), Jun 19 2002, 287(23) p3116-26
AUTHOR(S): Fairfield KM; Fletcher RH
AUTHOR'S ADDRESS: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. kfairfie@caregroup.harvard.edu.
PUBLICATION TYPE: Journal Article; Review; Review, Academic
CONCLUSIONS: Some groups of patients are at higher risk for vitamin deficiency and suboptimal vitamin status. Many physicians may be unaware of common food sources of vitamins or unsure which vitamins they should recommend for their patients. Vitamin excess is possible with supplementation, particularly for fat-soluble vitamins. Inadequate intake of several vitamins has been linked to chronic diseases, including coronary heart disease, cancer, and osteoporosis.

ARTICLE TITLE: Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair.
ARTICLE SOURCE: JAMA (United States), Jun 12 2002, 287(22) p2968-72
AUTHOR(S): Lederle FA; Johnson GR; Wilson SE; Ballard DJ; Jordan WD; Blebea J; Littooy FN; Freischlag JA; Bandyk D; Rapp JH; Salam AA
AUTHOR'S ADDRESS: Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minn 55417, USA. frank.lederle@med.va.gov; Collective Name: Veterans Affairs Cooperative Study #417 Investigators.
PUBLICATION TYPE: Journal Article; Multicenter Study
ABSTRACT: CONTEXT: Among patients with abdominal aortic aneurysm (AAA) who have high operative risk, repair is usually deferred until the AAA reaches a diameter at which rupture risk is thought to outweigh operative risk, but few data exist on rupture risk of large AAA.. CONCLUSION: The rupture rate is substantial in high-operative-risk patients with AAA of at least 5.5 cm in diameter and increases with larger diameter.
MB. Hardly anyone is too high a risk for endoluminal AAA repair.

ARTICLE TITLE: New bioethics council offers no recommendations.
ARTICLE SOURCE: JAMA (United States), Jun 12 2002, 287(22) p2934-5
AUTHOR(S): Vastag B
PUBLICATION TYPE: News
MB. It's about embryo cloning. They gave up.

ARTICLE TITLE: Journal prestige, publication bias, and other characteristics associated with citation of published studies in peer-reviewed journals.
ARTICLE SOURCE: JAMA (United States), Jun 5 2002, 287(21) p2847-50
AUTHOR(S): Callaham M; Wears RL; Weber E
AUTHOR'S ADDRESS: Division of Emergency Medicine, University of California, San Francisco, CA 94143-0208, USA. mlc@medicine.ucsf.edu.
PUBLICATION TYPE: Journal Article
ABSTRACT: CONTEXT: Citation by other authors is important in the dissemination of published science, but factors predicting it are little studied. METHODS: To identify characteristics of published research predicting citation in other journals, we searched the Science Citations Index database for a standardized 3.5 years for all citations of published articles originally submitted to a 1991 emergency medicine specialty meeting. CONCLUSION: In this cohort of published research, commonly used measures of study methodology and design did not predict the frequency of citations or the importance of citing journals. Positive outcome bias was not evident. The impact factor of the original publishing journal was more important than any other variable, suggesting that the journal in which a study is published may be as important as traditional measures of study quality in ensuring dissemination.
MB. There are many possibilities to explain citation rates.

ARTICLE TITLE: Reporting number needed to treat and absolute risk reduction in randomized controlled trials.
ARTICLE SOURCE: JAMA (United States), Jun 5 2002, 287(21) p2813-4
AUTHOR(S): Nuovo J; Melnikow J; Chang D
AUTHOR'S ADDRESS: Department of Family and Community Medicine, University of California, Davis, 4860 Y St, Sacramento, CA 95817, USA. jim.nuovo@ucdmc.ucdavis.edu.
PUBLICATION TYPE: Journal Article
ABSTRACT: CONTEXT: Ongoing efforts to improve the quality of reporting for randomized controlled trials (RCTs) include the Consolidated Standards of Reporting Trials (CONSORT) statement. We examined the frequency of explicit reporting of the number needed to treat (NNT) and the absolute risk reduction (ARR) in RCTs. METHODS: Five frequently cited journals were investigated: Annals of Internal Medicine, BMJ, JAMA, The Lancet, and the New England Journal of Medicine. CONCLUSIONS: Despite CONSORT recommendations, few authors expressed their findings in terms of NNT or ARR. Consideration should be given to including these values in reports of RCTs.

ARTICLE TITLE: Poor-quality medical research: what can journals do?
ARTICLE SOURCE: JAMA (United States), Jun 5 2002, 287(21) p2765-7
AUTHOR(S): Altman DG
AUTHOR'S ADDRESS: Cancer Research UK/NHS Centre for Statistics in Medicine, Institute of Health Sciences, Old Road, Headington, Oxford OX3 7LF, England. doug.altman@cancer.org.uk.
PUBLICATION TYPE: Journal Article
ABSTRACT: The aim of medical research is to advance scientific knowledge and hence--directly or indirectly--lead to improvements in the treatment and prevention of disease. Each research project should continue systematically from previous research and feed into future research. Each project should contribute beneficially to a slowly evolving body of research. A study should not mislead; otherwise it could adversely affect clinical practice and future research. In 1994 I observed that research papers commonly contain methodological errors, report results selectively, and draw unjustified conclusions. Here I revisit the topic and suggest how journal editors can help.
MB. How about publishing less?

ARTICLE TITLE: Fourth International Congress on Peer Review in Biomedical Publication.
ARTICLE SOURCE: JAMA (United States), Jun 5 2002, 287(21) p2759-60
AUTHOR(S): Rennie D
PUBLICATION TYPE: Congresses; Editorial

ARTICLE TITLE: The hidden research paper.
ARTICLE SOURCE: JAMA (United States), Jun 5 2002, 287(21) p2775-8
AUTHOR(S): Horton R
AUTHOR'S ADDRESS: The Lancet, 32 Jamestown Rd, London NW1 78Y, England. richard.horton@lancet.com.
PUBLICATION TYPE: Journal Article
ABSTRACT: CONTEXT: To determine whether the views expressed in a research paper are accurate representations of contributors' opinions about the research being reported. METHODS: Purposive sampling of 10 research articles published in The Lancet; qualitative analysis of answers to 6 questions about the meaning of the study put to contributors who were listed on the byline of these articles. Fifty-four contributors listed on the bylines of the 10 articles were evaluated, and answers to questions were compared between contributors within research groups and against the published research report. RESULTS: A total of 36 (67%) of 54 contributors replied to this survey. Important weaknesses were often admitted on direct questioning but were not included in the published article. Contributors frequently disagreed about the importance of their findings, implications, and directions for future research. I could find no effort to study systematically past evidence relating to the investigators' own findings in either survey responses or the published article. Overall, the diversity of contributor opinion was commonly excluded from the published report. I found that discussion sections were haphazardly organized and did not deal systematically with important questions about the study. CONCLUSIONS: A research paper rarely represents the opinions of those scientists whose work it reports. The findings described herein reveal evidence of (self-)censored criticism, obscured meanings, confused assessment of implications, and failures to indicate directions for future research. There is now empirical support for the introduction of structured discussion sections in research papers. Editors might also explore ways to recover the plurality of contributors' opinions.
MB. You can't expect particular publications to embody reality. Such expectation is a form of (book) fundamentalism.

ARTICLE TITLE: Noninvasive ventilation for acute respiratory failure
ARTICLE SOURCE: JAMA (United States), Aug 28 2002, 288(8) p932-5
AUTHOR(S): Brochard L
AUTHOR'S ADDRESS: Service de Reanimation Medicale, Hopital Henri Mondor, 94010 Creteil Cedex, France. laurent.brochard@hmn.ap-hop-paris.fr.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: From the Centers for Disease Control. Staphylococcus aureus resistant to vancomycin--United States, 2002.
ARTICLE SOURCE: JAMA (United States), Aug 21 2002, 288(7) p824-5
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock.
COMMENTS: Comment In: Comment In: RefSource:JAMA. 2002 Aug 21; 288(7):886-7
ARTICLE SOURCE: JAMA (United States), Aug 21 2002, 288(7) p862-71
AUTHOR(S): Annane D; Sebille V; Charpentier C; Bollaert PE; Francois B; Korach JM; Capellier G; Cohen Y; Azoulay E; Troche G; Chaumet-Riffaut P; Bellissant E
AUTHOR'S ADDRESS: Service de Reanimation Medicale, Hopital Raymond Poincare, 104 Blvd Raymond Poincare, 92380 Garches, France. djillali.annane@rpc.ap-hop-paris.fr.
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
ABSTRACT: CONTEXT: Septic shock may be associated with relative adrenal insufficiencyPATIENTS: Three hundred adult patients who fulfilled usual criteria for septic shock were enrolled after undergoing a short corticotropin test. INTERVENTION: Patients were randomly assigned to receive either hydrocortisone (50-mg intravenous bolus every 6 hours) and fludrocortisone (50- micro g tablet once daily) (n = 151) or matching placebos (n = 149) for 7 days. CONCLUSION: In our trial, a 7-day treatment with low doses of hydrocortisone and fludrocortisone significantly reduced the risk of death in patients with septic shock and relative adrenal insufficiency without increasing adverse events.

ARTICLE TITLE: Impact of cataract surgery on motor vehicle crash involvement by older adults.
COMMENTS: Comment In: Comment In: RefSource:JAMA. 2002 Aug 21; 288(7):885-6
ARTICLE SOURCE: JAMA (United States), Aug 21 2002, 288(7) p841-9
AUTHOR(S): Owsley C; McGwin G; Sloane M; Wells J; Stalvey BT; Gauthreaux S
AUTHOR'S ADDRESS: Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, 700 S 18th St, Suite 609, Birmingham, AL 35294-0009, USA. owsley@eyes.uab.edu.
PUBLICATION TYPE: Journal Article; Multicenter Study
. CONCLUSIONS: In our sample, patients with cataract who underwent cataract surgery and intraocular lens implantation had half the rate of crash involvement during the follow-up period compared with cataract patients who did not undergo surgery.
MB. I suppose they could now see.

ARTICLE TITLE: Hand-rubbing with an aqueous alcoholic solution vs traditional surgical hand-scrubbing and 30-day surgical site infection rates: a randomized equivalence study.
ARTICLE SOURCE: JAMA (United States), Aug 14 2002, 288(6) p722-7
AUTHOR(S): Parienti JJ; Thibon P; Heller R; Le Roux Y; von Theobald P; Bensadoun H; Bouvet A; Lemarchand F; Le Coutour X AUTHOR'S ADDRESS: Departments of Infectious Diseases and Intensive Care Unit, Cote de Nacre University Hospital Centre, 14 033 Caen Cedex, France. parienti@u444.jussieu.fr; Collective Name: Antisepsie Chirurgicale des mains Study Group.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: Hand-rubbing with aqueous alcoholic solution, preceded by a 1-minute nonantiseptic hand wash before each surgeon's first procedure of the day and before any other procedure if the hands were soiled, was as effective as traditional hand-scrubbing with antiseptic soap in preventing surgical site infections. The hand-rubbing protocol was better tolerated by the surgical teams and improved compliance with hygiene guidelines. Hand-rubbing with liquid aqueous alcoholic solution can thus be safely used as an alternative to traditional surgical hand-scrubbing.

ARTICLE TITLE: Psychological reactions to terrorist attacks: findings from the National Study of Americans' Reactions to September 11.
COMMENTS: Comment In: Comment In: RefSource:JAMA. 2002 Aug 7; 288(5):633-6/PMID:12150676
ARTICLE SOURCE: JAMA (United States), Aug 7 2002, 288(5) p581-8
AUTHOR(S): Schlenger WE; Caddell JM; Ebert L; Jordan BK; Rourke KM; Wilson D; Thalji L; Dennis JM; Fairbank JA; Kulka RA AUTHOR'S ADDRESS: Center for Risk Behavior and Mental Health Research, Research Triangle Institute, PO Box 12194, Research Triangle Park, NC 27709, USA. bs@rti.org.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: One to 2 months following the events of September 11, probable Posttraumatic Stress Disorder (PTSD) was associated with direct exposure to the terrorist attacks among adults, and the prevalence in the New York City metropolitan area was substantially higher than elsewhere in the country. However, overall distress levels in the country were within normal ranges.

ARTICLE TITLE: Preoperative haemoglobin concentration and mortality rate after coronary artery bypass surgery.
ARTICLE SOURCE: Lancet (England), May 18 2002, 359(9319) p1747-8
AUTHOR(S): Zindrou D; Taylor KM; Bagger JP
AUTHOR'S ADDRESS: Cardiothoracic Directorate, Faculty of Medicine, Imperial College School of Science, Technology and Medicine, Hammersmith Hospital, London W12 0NN, UK.
PUBLICATION TYPE: Journal Article
Our findings suggest that a low haemoglobin concentration is a marker of disease severity or comorbidity that has a major effect on survival rate.

ARTICLE TITLE: Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: a randomised controlled trial.
COMMENTS: Comment In: Comment In: RefSource:Lancet. 2002 May 25; 359(9320):1792-3
ARTICLE SOURCE: Lancet (England), May 25 2002, 359(9320) p1812-8
AUTHOR(S): Lobo DN; Bostock KA; Neal KR; Perkins AC; Rowlands BJ; Allison SP
AUTHOR'S ADDRESS: Section of Surgery, University Hospital, Queen's Medical Centre, Nottingham, UK. dileep.lobo@nottingham.ac.uk.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
INTERPRETATION: Positive salt and water balance sufficient to cause a 3 kg weight gain after surgery delays return of gastrointestinal function and prolongs hospital stay in patients undergoing elective colonic resection.
MB. They did not prescribe intra-operative fluids and do not report what the anaesthetists did. They might well have given lots of intra-operative fluid

ARTICLE TITLE: Fluid restriction for postoperative patients?
COMMENTS: Comment On: Comment On: RefSource:Lancet. 2002 May 25; 359(9320):1812-8
ARTICLE SOURCE: Lancet (England), May 25 2002, 359(9320) p1792-3
AUTHOR(S): Heyland DK; Paterson WG
AUTHOR'S ADDRESS: Division of Gastroenterology, Department of Medicine, Queen's University, Kingston, Ontario K7L 5G2, Canada. dkh2@post.queensu.ca.
PUBLICATION TYPE: Comment; Journal Article
MB. About the preceeding paper. They are only interested in return of GI function & don't mention the renal system.

ARTICLE TITLE: Magnesium for preventing and treating eclampsia: time for international action.
COMMENTS: Comment On: Comment On: RefSource:Lancet. 2002 Jun 1; 359(9321):1877-90
ARTICLE SOURCE: Lancet (England), Jun 1 2002, 359(9321) p1872-3
AUTHOR(S): Sheth SS; Chalmers I
AUTHOR'S ADDRESS: 2/2 Navjivan Society, Lamington Road, Mumbai 400 008, India. silsal@bom2.vsnl.net.in.
PUBLICATION TYPEComment; Journal Article

ARTICLE TITLE: Off-pump coronary artery bypass grafting.
ARTICLE SOURCE: Lancet (England), Jul 27 2002, 360(9329) p327-30
AUTHOR(S): Abu-Omar Y; Taggart DP
AUTHOR'S ADDRESS: Department of Cardiac Surgery, Oxford Heart Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease.
COMMENTS: Comment On: Comment On: RefSource:Lancet. 2002 Jul 20; 360(9328):203-10
ARTICLE SOURCE: Lancet (England), Jul 20 2002, 360(9328) p187-95
AUTHOR'S ADDRESS: Collective Name: Collaborative Group on Hormonal Factors in Breast Cancer.
PUBLICATION TYPE: Comment; Journal Article; Review; Review, Academic
INTERPRETATION: The longer women breast feed the more they are protected against breast cancer. The lack of or short lifetime duration of breastfeeding typical of women in developed countries makes a major contribution to the high incidence of breast cancer in these countries.

ARTICLE TITLE: Two decades of progress in preventing vascular disease.
COMMENTS: Comment On: Comment On: RefSource:Lancet. 2002 Jul 6; 360(9326):23-33; Comment On: Comment On: RefSource:Lancet. 2002 Jul 6; 360(9326):7-22
ARTICLE SOURCE: Lancet (England), Jul 6 2002, 360(9326) p2-3
AUTHOR(S): Yusuf S
AUTHOR'S ADDRESS: Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada L8L 2X2. yusufs@mcmaster.ca.
PUBLICATION TYPE: Comment; Journal Article
MB. About medical treatment.

ARTICLE TITLE: Can clinical reasoning be taught or can it only be learned?
ARTICLE SOURCE: Med Educ (England), Aug 2002, 36(8) p695-6
AUTHOR(S): Schuwirth L
AUTHOR'S ADDRESS: Maastricht, The Netherlands.
PUBLICATION TYPE: Journal Article
MB. He speculates about new types of medical courses but does not really suggest much hope of inducing reasoning.

ARTICLE TITLE: Anatomy 1999-2000: the curriculum, who teaches it and how
ARTICLE SOURCE: Med Educ (England), Aug 2002, 36(8) p702-10
AUTHOR(S): Heylings DJ
PUBLICATION TYPE: Journal Article
CONCLUSIONS: There is considerable variation in duration and staffing of anatomy teaching, according to the type of curriculum. This suggests there may well be substantial variation in the level, content and depth of anatomical curricula across the country, and that this should be quantified.
MB. It is odd that anatomy seems to be going away when it's the essence of cardiology, neurology & surgery at least.

ARTICLE TITLE: A pre-employment programme for overseas-trained doctors entering the Australian workforce, 1997-99
ARTICLE SOURCE: Med Educ (England), Jul 2002, 36(7) p614-21
AUTHOR(S): Sullivan EA; Willcock S; Ardzejewska K; Slaytor EK
AUTHOR'S ADDRESS: Postgraduate Medical Council of New South Wales, Australia. esullivan@unsw.edu.au.
PUBLICATION TYPE: Journal Article

ARTICLE TITLE: Improving learning of a clinical skill: the first year's experience of teaching endotracheal intubation in a clinical simulation facility
ARTICLE SOURCE: Med Educ (England), Jul 2002, 36(7) p635-42
AUTHOR(S): Owen H; Plummer JL
AUTHOR'S ADDRESS: Department of Anaesthesia, Flinders University of South Australia and Flinders Medical Centre, Bedford Park, South Australia.
PUBLICATION TYPE: Journal Article
ABSTRACT: BACKGROUND: All medical practitioners should be able to manage the airway of an unconscious patient. Endotracheal intubation is the most effective method of securing the airway but is a complex skill requiring much practice. Traditionally, endotracheal intubation has been taught on patients, but this is not ideal. METHODS: We have developed a short course on endotracheal intubation taught in a clinical simulation unit (CSU). This unit has a large range of airway trainers and patient simulators, some of which can be manipulated to make intubation more difficult. Endotracheal intubation is taught in a series of steps in order to avoid cognitive overload. Each step is taught on an airway trainer that has no difficult features. Once this is mastered, more difficult situations are presented which require application of new techniques and/or equipment. In this way, students learn useful schemas to apply clinically. RESULTS: In 1 year, over 100 students and trainees were taught endotracheal intubation in the CSU. The ideal group size was found to be two students and one trainer. It took 75 to 90 minutes for most students to reach a standard where they could be expected to safely perform the technique on a patient. All comments on learning endotracheal intubation in this setting were positive. Many students felt more comfortable learning on a model than on a patient. CONCLUSION: Learning clinical procedures on simulators is becoming an essential part of medical education. More than one airway trainer may be needed to give students the expertise to perform endotracheal intubation on patients.
MB. I am yet to see a realistic intubation simulator.

ARTICLE TITLE: Medical education research: is there virtue in eclecticism?
ARTICLE SOURCE: Med Educ (England), Jun 2002, 36(6) p502-3
AUTHOR(S): Prideaux D
PUBLICATION TYPE: Editorial
MB. I think this is suggesting that change might produce some alteration in outcome but I don't think that the appropriate research is being set up & I really can't imagine how it could be. My casual observations are that the products of the new types of courses are the same as those from traditional courses.

ARTICLE TITLE: Nurse-staffing levels and the quality of care in hospitals.
COMMENTS: Comment In: Comment In: RefSource:N Engl J Med. 2002 May 30; 346(22):1757-66
ARTICLE SOURCE: N Engl J Med (United States), May 30 2002, 346(22) p1715-22
AUTHOR(S): Needleman J; Buerhaus P; Mattke S; Stewart M; Zelevinsky K
AUTHOR'S ADDRESS: Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass 02115, USA. needlema@hsph.harvard.edu.
PUBLICATION TYPE: Journal Article
MB. They compared hours of nursing attendence with various outcomes. I don't think this is a very sensible exercise.

ARTICLE TITLE: Nursing in the crossfire.
COMMENTS: Comment On: Comment On: RefSource:N Engl J Med. 2002 May 30; 346(22):1715-22
ARTICLE SOURCE: N Engl J Med (United States), May 30 2002, 346(22) p1757-66
AUTHOR(S): Steinbrook R
PUBLICATION TYPE: Comment; Journal Article
MB. It looks as though there will be no nurses soon.

ARTICLE TITLE: Kidney transplantation from donors without a heartbeat.
COMMENTS: Comment In: Comment In: RefSource:N Engl J Med. 2002 Jul 25; 347(4):281-3
ARTICLE SOURCE: N Engl J Med (United States), Jul 25 2002, 347(4) p248-55
AUTHOR(S): Weber M; Dindo D; Demartines N; Ambuhl PM; Clavien PA
AUTHOR'S ADDRESS: Department of Visceral Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: Although the incidence of delayed graft function is significantly higher with kidneys from donors without a heartbeat than with kidneys from donors with a heartbeat, there is no difference in long-term outcome between the two types of graft.
MB. They have been saying this for years

ARTICLE TITLE: Is placebo surgery unethical?
COMMENTS: Comment On: Comment On: RefSource:N Engl J Med. 2002 Jul 11; 347(2):81-83
ARTICLE SOURCE: N Engl J Med (United States), Jul 11 2002, 347(2) p137-9
AUTHOR(S): Horng S; Miller FG
AUTHOR'S ADDRESS: National Institutes of Health, Bethesda, MD 20892-1156, USA.
PUBLICATION TYPE:Comment; Journal Article

ARTICLE TITLE: Hypocapnia.
ARTICLE SOURCE: N Engl J Med (United States), Jul 4 2002, 347(1) p43-53
AUTHOR(S): Laffey JG; Kavanagh BP
AUTHOR'S ADDRESS: Department of Physiology, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.
PUBLICATION TYPE Journal Article; Review; Review, Tutorial

ARTICLE TITLE: Cardiac resynchronization in chronic heart failure.
COMMENTS: Comment In: Comment In: RefSource:N Engl J Med. 2002 Jun 13; 346(24):1902-5/PMID:12063376
ARTICLE SOURCE: N Engl J Med (United States), Jun 13 2002, 346(24) p1845-53
AUTHOR(S): Abraham WT; Fisher WG; Smith AL; Delurgio DB; Leon AR; Loh E; Kocovic DZ; Packer M; Clavell AL; Hayes DL; Ellestad M; Trupp RJ; Underwood J; Pickering F; Truex C; McAtee P; Messenger J
AUTHOR'S ADDRESS: Division of Cardiovascular Medicine, University of Kentucky College of Medicine, Lexington 40536-0284, USA. wtabra2@uky.edu; Collective Name: MIRACLE Study Group. Multicenter InSync Randomized Clinical Evaluation.
PUBLICATION TYPE: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
CONCLUSIONS: Cardiac resynchronization results in significant clinical improvement in patients who have moderate-to-severe heart failure and an intraventricular conduction delay.

ARTICLE TITLE: What's ahead for health insurance in the United States?
ARTICLE SOURCE: N Engl J Med (United States), Jun 6 2002, 346(23) p1822-4
AUTHOR(S): Fuchs VR
AUTHOR'S ADDRESS: Stanford University, Stanford, CA 94305, USA.
PUBLICATION TYPE: Journal Article
MB. Chaos.

ARTICLE TITLE: High-frequency oscillatory ventilation versus conventional mechanical ventilation for very-low-birth-weight infants
ARTICLE SOURCE: N Engl J Med (United States), Aug 29 2002, 347(9) p643-52
AUTHOR(S): Courtney SE; Durand DJ; Asselin JM; Hudak ML; Aschner JL; Shoemaker CT
AUTHOR'S ADDRESS: Division of Neonatology, Cooper Hospital-University Medical Center, Camden, NJ, USA. scourtney@lij.edu; Collective Name: Neonatal Ventilation Study Group.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: There was a small but significant benefit of high-frequency oscillatory ventilation in terms of the pulmonary outcome for very-low-birth-weight infants without an increase in the occurrence of other complications of premature birth.

ARTICLE TITLE: Experiences of Oregon nurses and social workers with hospice patients who requested assistance with suicide.
ARTICLE SOURCE: N Engl J Med (United States), Aug 22 2002, 347(8) p582-8
AUTHOR(S): Ganzini L; Harvath TA; Jackson A; Goy ER; Miller LL; Delorit MA
AUTHOR'S ADDRESS: Mental Health Division, Portland Veterans Affairs Medical Center, Portland, OR 97207, USA. ganzinil@ohsu.edu.
PUBLICATION TYPE: Journal Article
MB. A postal survey

ARTICLE TITLE: Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation.
ARTICLE SOURCE: N Engl J Med (United States), Aug 22 2002, 347(8) p567-75
AUTHOR(S): Fisher B; Jeong JH; Anderson S; Bryant J; Fisher ER; Wolmark N
AUTHOR'S ADDRESS: National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA 15212-5234, USA. bernard.fisher@nsabp.org.
PUBLICATION TYPE: Journal Article
CONCLUSIONS: The findings validate earlier results showing no advantage from radical mastectomy. Although differences of a few percentage points cannot be excluded, the findings fail to show a significant survival advantage from removing occult positive nodes at the time of initial surgery or from radiation therapy.

ARTICLE TITLE: Comparison of stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery.
COMMENTS: Comment In: Comment In: RefSource:N Engl J Med. 2002 Aug 22; 347(8):551-2
ARTICLE SOURCE: N Engl J Med (United States), Aug 22 2002, 347(8) p561-6
AUTHOR(S): Diegeler A; Thiele H; Falk V; Hambrecht R; Spyrantis N; Sick P; Diederich KW; Mohr FW; Schuler G
AUTHOR'S ADDRESS: Department of Cardiac Surgery, University of Leipzig Heart Center, Leipzig, Germany.
PUBLICATION TYPE: Clinical Trial; Journal Article; Randomized Controlled Trial
CONCLUSIONS: In patients with isolated high-grade lesions of the proximal left anterior descending artery, both minimally invasive bypass surgery and stenting are effective. Stenting yields excellent short-term results with fewer periprocedural adverse events, but surgery is superior with regard to the need for repeated intervention in the target vessel and freedom from angina at six months of follow-up.

ARTICLE TITLE: Angioplasty versus minimally invasive bypass surgery.
COMMENTS: Comment On: Comment On: RefSource:N Engl J Med. 2002 Aug 22; 347(8):561-6
ARTICLE SOURCE: N Engl J Med (United States), Aug 22 2002, 347(8) p551-2
AUTHOR(S): MacGillivray TE; Vlahakes GJ
AUTHOR'S ADDRESS: Massachusetts General Hospital, Boston, MA 02114, USA.
PUBLICATION TYPE: Comment; Journal Article

ARTICLE TITLE: HIV drug resistance - a chink in the armor.
COMMENTS: Comment On: Comment On: RefSource:N Engl J Med. 2002 Aug 8; 347(6):385-94
ARTICLE SOURCE: N Engl J Med (United States), Aug 8 2002, 347(6) p438-9
AUTHOR(S): Hirsch MS
PUBLICATION TYPE: Comment; Editorial
MB. New infections are occuring with resistant viruses

ARTICLE TITLE: Knocking out the DREAM to study pain.
ARTICLE SOURCE: N Engl J Med (United States), Aug 1 2002, 347(5) p362-4
AUTHOR(S): Vogt BA
AUTHOR'S ADDRESS: State University of New York Upstate Medical University, Syracuse, NY 13210, USA.
PUBLICATION TYPE: Journal Article; Review; Review, Tutorial
MB. This is wishful thinking which might result in therapeutic progress in pain but not yet. It's not worth trying to follow the speculation now.

ARTICLE TITLE: Invited commentary: financial implications of early hospital discharge and readmission.
COMMENTS: Comment On: Comment On: RefSource:Surgery. 2002 Jul; 132(1):10-5
ARTICLE SOURCE: Surgery (United States), Jul 2002, 132(1) p16
AUTHOR(S): Lahey SJ
AUTHOR'S ADDRESS: Department of Surgery, Division of Cardiothoracic Surgery, University of Massachusetts Medical School, Worcester 01655, USA.
PUBLICATION TYPE: Comment; Journal Article

ARTICLE TITLE: The pulmonary physician in critical care: ventilator induced lung injury.
ARTICLE SOURCE: Thorax (England), Jul 2002, 57(7) p635-42
AUTHOR(S): Whitehead T; Slutsky AS
AUTHOR'S ADDRESS: Department of Critical Care, St Michael's Hospital, Interdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada.
PUBLICATION TYPE: Review.