The Mount Sinai journal of medicine, New York
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Comparative Study
Comparison of arterial systolic pressure variation with other clinical parameters to predict the response to fluid challenges during cardiac surgery.
Prophylactic optimization of stroke volume during surgery has been thought by some to reduce complications following surgery. Mechanical ventilation has been shown to induce variations in systolic systemic arterial blood pressure. Measuring such variations in systolic pressure (SPV) might serve as an attractive method for guiding fluid therapy intraoperatively. ⋯ Although significant intergroup differences in the extent of systolic pressure variations were observed, no appropriate threshold values could be determined that would accurately predict the response to a fluid bolus. There is a relationship between SPV and SPVdown values and intravascular volume status. SPV and echocardiographic-derived values did not predict the response to a fluid bolus as well as values obtained from the pulmonary artery catheter.
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The practice of neuroanesthesia at the Mount Sinai Medical Center focused initially on clinical practice, followed by specialization. This article presents a brief history of the division and a description of the areas of interest, presentations, and publications that have originated there.
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Historical Article
The Mount Sinai Hospital's role in the development of anesthesia safety standards.
The Department of Anesthesiology of The Mount Sinai Hospital was closely involved in introducing anesthesia safety standards for anesthesia breathing systems, the introduction of the first disposable plastic anesthesia breathing system, the layout of the controls on gas machines, nontoxic airways, safe ethylene oxide sterilization and safe obstetrical anesthesia.
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Historical Article
Anesthesiologists and surgeons at Mount Sinai: a partnership in excellence.
Although anesthesia was available to patients when the doors of The Jews Hospital opened in 1855, "professional anesthetists" were not appointed to the staff until 1902. This article traces the history of the anesthesiology staff and department, and documents their accomplishments over the past century.
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Case Reports
Pneumococcal vaccine failure in an HIV-infected patient with fatal pneumococcal sepsis and HCV-related cirrhosis.
Pneumoccocal vaccination of HIV-positive individuals is recommended to prevent pneumococcal infection. We present a case of a 44-year-old HIV-infected male who came to the emergency room with bacterial pneumonia and sepsis. The patient also had a history of HBV and HCV infection. ⋯ The patient had received Pneumovax two years before his death. The organism isolated from blood cultures was Streptococcus pneumoniae isotype 3, a strain included in Pneumovax. This is a case of pneumococcal vaccine failure with a fatal outcome in a person with an HIV infection and hepatitis C-related liver cirrhosis.