Anesthesiology
-
Patient blood management programs are gaining popularity as quality improvement and patient safety initiatives, but methods for implementing such programs across multihospital health systems are not well understood. Having recently incorporated a patient blood management program across our health system using a clinical community approach, we describe our methods and results. ⋯ Implementing a health system-wide patient blood management program by using a clinical community approach substantially reduced blood utilization and blood acquisition costs.
-
Historical Article
Earliest English Definitions of Anaisthesia and Anaesthesia.
The earliest identified English definition of the word anaisthesia was discovered in the first edition (1684) of A Physical Dictionary, an English translation of Steven Blankaart's medical dictionary, Lexicon Medicum Graeco-Latinum. This definition was almost certainly the source of the definition of anaesthesia which appeared in Dictionarium Anglo-Britannicum (1708), a general-purpose English dictionary compiled by the lexicographer John Kersey. The words anaisthesia and anaesthesia have not been identified in English medical or surgical publications that antedate the earliest English dictionaries in which they are known to have been defined.
-
Observational Study
Are Anesthesia and Surgery during Infancy Associated with Decreased White Matter Integrity and Volume During Childhood?
Anesthetics have neurotoxic effects in neonatal animals. Relevant human evidence is limited. We sought such evidence in a structural neuroimaging study. ⋯ Children who had anesthesia and surgery during infancy showed broadly distributed, decreased white matter integrity and volume. Although the findings may be related to anesthesia and surgery during infancy, other explanations are possible.
-
Prolonged opioid administration leads to tolerance characterized by reduced analgesic potency. Pain management is additionally compromised by the hedonic effects of opioids, the cause of their misuse. The multifunctional protein β-arrestin2 regulates the hedonic effects of morphine and participates in tolerance. These actions might reflect µ opioid receptor up-regulation through reduced endocytosis. β-Arrestin2 also recruits kinases to µ receptors. We explored the role of Src kinase in morphine analgesic tolerance, locomotor stimulation, and reinforcement in C57BL/6 mice. ⋯ The ability of c-Src inhibitors to inhibit tolerance, thereby restoring analgesia, without altering the hedonic effect of morphine, makes c-Src inhibitors promising candidates as adjuncts to opioid analgesics.