Clinical Effectiveness of Incentive Spirometry for the Prevention of Postoperative Pulmonary Complications.

Incentive spirometry (IS) is commonly prescribed to reduce pulmonary complications, despite limited evidence to support its benefits and a lack of consensus on optimal protocols for its use. Although numerous studies and meta-analyses have examined the effects of IS on patient outcomes, there is no clear evidence establishing its benefit to prevent postoperative pulmonary complications. Clinical practice guidelines advise against the routine use of IS in postoperative care.

A Comparison of Web-Based with Traditional Classroom-Based Training of Lung Ultrasound for the Exclusion of Pneumothorax.

Background: Lung ultrasound (LUS) is a well-established method that can exclude pneumothorax by demonstration of pleural sliding and the associated ultrasound artifacts. The positive diagnosis of pneumothorax is more difficult to obtain and relies on detection of the edge of a pneumothorax, called the "lung point." Yet, anesthesiologists are not widely taught these techniques, even though their patients are susceptible to pneumothorax either through trauma or as a result of central line placement or regional anesthesia techniques performed near the thorax.

The use of emergency manuals in perioperative crisis management: a cautious approach.

When an unexpected perioperative crisis arises, simulation studies have suggested that the use of an emergency manual (EM) may offset the large cognitive load involved in crisis management, facilitating the efficient performance of key steps in treatment. However, little is known about how well EMs will translate into actual practice and what is required to use them optimally. While EMs are a promising tool in the management of perioperative critical events, more research is needed to define best practices and their limitations.

Brain-derived neurotrophic factor Val66Met polymorphism and cognitive function in persons with cardiovascular disease.

Aim: Cognitive impairment is common among persons with cardiovascular disease (CVD), and several potential aetiological mechanisms have been described, including contributions of genetic markers such as variations in the brain-derived neurotrophic (BDNF) gene. This current study examined the associations of BDNF genotype with cognitive function among individuals with CVD.

Methods: This study included 110 participants with CVD who completed a comprehensive neuropsychological battery that assessed global cognitive function, attention/executive function, memory, language, and visuospatial abilities.

Invalid performance and the ImPACT in national collegiate athletic association division I football players.

Context: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a computerized cognitive test battery commonly used for concussion evaluation. An important aspect of these procedures is baseline testing, but researchers have suggested that many users do not use validity indices to ensure adequate effort during testing. No one has examined the prevalence of invalid performance for college football players.

Review article: Intrapartum neuraxial analgesia and breastfeeding outcomes: limitations of current knowledge.

Although numerous studies have addressed the relationship between intrapartum neuraxial analgesia, particularly epidural fentanyl, and breastfeeding, substantial study design limitations have precluded the current literature from furnishing strong, clinically significant conclusions. Lack of randomized controlled trials, nonstandardization of breastfeeding evaluations across studies, and failure to control for confounding variables all pose significant problems. Further research is needed to elucidate the specific relationship between neuraxial opioids and breastfeeding and, if there are significant associations, whether these drugs act directly on neonatal brain tissue to attenuate exhibition of breastfeeding behaviors.

Sleep and cognition in older adults with cardiovascular disease.

Background: Sleep problems are common in the normal population and likely to be especially prevalent in persons with cardiovascular disease.

Purpose: We examined the prevalence of sleep difficulties and their impact on cognitive function in 77 persons (mean age, 62.8 [SD, 12.

Reduced executive functioning is associated with poorer outcome in cardiac rehabilitation.

Patients with cardiovascular disease and cognitive impairment show reduced adherence to treatment. No study has examined whether cognitive impairment may also predict reduced benefit from cardiac rehabilitation (CR). It appears that cognitively impaired patients may exhibit poorer adherence to CR and limited gains in cardiovascular fitness and/or quality of life (QOL).