An FDA advisory committee voted 6-4 against expanding approved indications for liposomal bupivicaine for regional pain control after surgery. This drug is a central element in many institutions' Enhanced Recovery After Surgery programs. They cited inconsistent results, failure to provide comparative results, and increased deaths associated with the
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Vascular
February 17, 2018
A balanced comment on the occasion of the latest retrospective nonrandomised Coselli report on redo thoracoabdominal aortic aneurysms (TAAAs).
February 14, 2018
Wang and colleagues present a systematic review of outcomes reported in 26 articles for 67 patients who underwent endovascular treatment for diseases of the ascending aorta, excluding type A dissection. The authors expect a gain in popularity of this intervention in select high-risk patients, but they consider further analysis necessary.
February 14, 2018
Interesting article commenting on the perception that some remedies in medicine are so obviously beneficial that testing their effectiveness is a waste of time. As it turns out, many of what physicians think are "slam dunk" remedies have mixed or negative results.
February 2, 2018
This review included 55 publications covering 141 cohort studies. The authors found that the relative risk of stroke associated with smoking just one cigarette a day was 1.25 to 1.31, and for coronary artery disease it was 1.48 to 1.57. There is no safe level of smoking.
January 25, 2018
Schneider and colleagues have narrated a video demonstrating their technique for valve-sparing root replacement in a patient with Marfan syndrome. In the accompanying article, the authors report the outcomes of 61 patients with Marfan syndrome who underwent either aortic valve reimplantation or root remodeling at their institution.
January 22, 2018
A model analysis of a phase I surgical device trial. The readable editorial discusses the adoption of surgical innovation on the occasion of a harmonic sealing device for pulmonary resections, highlighting the problem of ligating small branches of the pulmonary artery in confined spaces.
January 18, 2018
The authors describe a clinical unit developed at their institution designed to implement "nudges" to help improve health care delivery, primarily through the EMR. "Nudges" have been used to shape other behaviors, such as offering opt-out (rather than opt-in) for organ donor status to encourage increased organ donation. The concept was described
January 18, 2018
The authors summarize the rationale and utility of point of care ultrasonography for identifying factors associated with hypotension or hypoxia in a deteriorating surgical patient, including hypovolemia, LV dysfunction, PE, pleural fluid, ascites, etc. Their claim is that a variety of other diagnostic measures are less accurate, and that a single ul
January 16, 2018
This video demonstrates a stage I elephant trunk procedure and aortic valve repair via partial sternotomy, for a woman who presented with aortic valve insufficiency and an aortic aneurysm extending from the ascending to descending thoracic aorta.