Weekly Medical News

We’re really not sure of the cardiovascular impact of cannabis  link

The current influenza outbreak one of the worst since 2009 swine flu, many children dying  link

Left atrial appendage electrical isolation associated with lower AFib/tachy recurrence. It should perhaps be closed at all cardiac surgeries.  link

Adding Coronary Artery Calcium score improves risk classification in diabetes/metabolic syndrome link

On ICU discharge, discontinuity in documentation, patient story and decision making common link

Longer time from breast cancer diagnosis to surgery associated with reduced survival link

FDA limits loperamide (Imodium) packaging and doses due to misuse/abuse & cardiotoxicity link

Diabetes and hypertension rates high in India link

Living kidney donors have a higher relative risk of ESRD, absolute risk low link

Early intervention in economically disadvantaged children results in higher midlife educational attainment link

Delay in first line benzo treatment for refractory convulsive status epilepticus leads to higher mortality link

Experts urge addition of folic acid to flour to prevent birth defects  link

Amazon, Berkshire, JPMorgan to enter healthcare market to cut employees costs Reuters link

– and hospitals themselves want to make their own drugs link

1 in 3 physicians has been sued; by age 55, 1 in 2 hit with suit. Two thirds fail/dismiss but costs and stress add up link

Fentanyl, or possibly it’s combination with cocaine tied to persisting amnesia in substance abuse link

A strong link between migraine and heart, stroke and thromboembolism risk link

Omega 3 supplementation for cardiovascular disease risk reduction not supported by evidence link

No benefit on composite outcomes for aspirin in heart failure without AFib link

Catheter ablation of AFib with heart failure may improve mortality amd outcomeslink

Adolescents with a history of congenital or acquired kidney disorders had a fourfold excess risk for developing end-stage renal disease up to 30 years later link

Dementia prevention strategies (medications, OTC supplements, exercise, cognitive training) all have insufficient evidence in National Institute on Aging review. Overall health strategies best bet for now. link

Unnecessary medical care runs rampant link

 

Esmolol Analgesia?

Many are replacing Fentanyl with Esmolol during anesthesia. No direct analgesic effect of esmolol could be demonstrated in this study. The postoperative opioid-sparing effect demonstrated in previous studies, could therefore be secondary to other factors such as avoidance of opioid-induced hyperalgesia, synergy with coadministered opioids or altered pharmacokinetics of those drugs.

eja link

Freemantle Glottic View Scoring

Instead of direct laryngoscopy scores like Cormack-Lehane or POGO, the increasing use of videolaryngoscopy may mandate a different description, as a C-L 1 view on video may not correlate with direct view scores.

The Fremantle Score is one worth documenting in our records – view, ease and device used

Authors review here

And don’t forget to document ease of face mask ventilation, airway use and supraglottic airway issues.