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RANDOMIZED CONTROLLED TRIAL
Annelies T Moerman, Valerie M Vanbiervliet, Astrid Van Wesemael, Stefaan M Bouchez, Patrick F Wouters, Stefan G De Hert
BACKGROUND: Previous work has demonstrated paradoxical increases in cerebral oxygen saturation (ScO2) as blood pressure decreases and paradoxical decreases in ScO2 as blood pressure increases. It has been suggested that these paradoxical responses indicate a functional cerebral autoregulation mechanism. Accordingly, the authors hypothesized that if this suggestion is correct, paradoxical responses will occur exclusively in patients with intact cerebral autoregulation. METHODS: Thirty-four patients undergoing elective cardiac surgery were included...
August 2015: Anesthesiology
#22
JOURNAL ARTICLE
Amy J Starmer, Nancy D Spector, Rajendu Srivastava, Daniel C West, Glenn Rosenbluth, April D Allen, Elizabeth L Noble, Lisa L Tse, Anuj K Dalal, Carol A Keohane, Stuart R Lipsitz, Jeffrey M Rothschild, Matthew F Wien, Catherine S Yoon, Katherine R Zigmont, Karen M Wilson, Jennifer K O'Toole, Lauren G Solan, Megan Aylor, Zia Bismilla, Maitreya Coffey, Sanjay Mahant, Rebecca L Blankenburg, Lauren A Destino, Jennifer L Everhart, Shilpa J Patel, James F Bale, Jaime B Spackman, Adam T Stevenson, Sharon Calaman, F Sessions Cole, Dorene F Balmer, Jennifer H Hepps, Joseph O Lopreiato, Clifton E Yu, Theodore C Sectish, Christopher P Landrigan
BACKGROUND: Miscommunications are a leading cause of serious medical errors. Data from multicenter studies assessing programs designed to improve handoff of information about patient care are lacking. METHODS: We conducted a prospective intervention study of a resident handoff-improvement program in nine hospitals, measuring rates of medical errors, preventable adverse events, and miscommunications, as well as resident workflow. The intervention included a mnemonic to standardize oral and written handoffs, handoff and communication training, a faculty development and observation program, and a sustainability campaign...
November 6, 2014: New England Journal of Medicine
#23
JOURNAL ARTICLE
Alexander M Binshtok, Bruce P Bean, Clifford J Woolf
Most local anaesthetics used clinically are relatively hydrophobic molecules that gain access to their blocking site on the sodium channel by diffusing into or through the cell membrane. These anaesthetics block sodium channels and thereby the excitability of all neurons, not just sensory neurons. We tested the possibility of selectively blocking the excitability of primary sensory nociceptor (pain-sensing) neurons by introducing the charged, membrane-impermeant lidocaine derivative QX-314 through the pore of the noxious-heat-sensitive TRPV1 channel...
October 4, 2007: Nature
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