Evaluation of differences in patient and physician perception of benefit and risks of aspirin and antifibrinolytic therapy in cardiac surgery.

It is unclear whether physicians and patients have similar concerns and preferences when considering benefit and risks of aspirin and antifibrinolytic therapy for cardiac surgery. We surveyed both groups to ascertain their perceptions and preferences for treatment in this setting. Both preoperative and postoperative cardiac surgical patients and the physician craft groups caring for them (cardiology, surgery, anaesthesia/critical care), were provided with estimates of benefits and risks of aspirin and antifibrinolytic therapy.

Monitoring of brain function in anesthesia and intensive care.

Purpose Of Review: Despite its obvious importance, the brain is inconsistently the focus of monitoring in anesthesia and intensive care settings. However, there are multiple modalities available to address cerebral monitoring that when acted upon, may improve perioperative outcomes. This review addresses the various brain monitoring options that can be integrated in anesthetic and intensive care practice in order to optimize perioperative outcomes.

Lumbar cerebrospinal fluid drainage for thoracoabdominal aortic surgery: rationale and practical considerations for management.

Paraplegia remains one of the most devastating complications of thoracoabdominal aortic surgery and is associated with a significant increase in both morbidity and mortality. Modern aortic repair techniques use many modalities aimed at reducing the risk of spinal cord ischemia inherent with surgical management. One of these modalities that acts via optimizing spinal cord blood flow is lumbar cerebrospinal fluid (CSF) drainage.

Cerebral monitoring to optimize outcomes after cardiac surgery.

Purpose Of Review: Although significant achievements have been made in the perioperative care of patients undergoing cardiac surgery, adverse cerebral outcomes remain an ongoing concern. Multiple approaches have been utilized to address neurologic complications, though definitive therapeutic strategies are lacking. This review focuses on the various cerebral monitoring options that can be used in cardiac surgery to improve perioperative outcomes.

Role of Ca2+ stores in dopamine- and PACAP-evoked growth hormone release in goldfish.

Growth hormone (GH) secretion, evoked by either pituitary adenylate cyclase-activating polypeptide (PACAP) or dopamine (DA), is dependent on both voltage-sensitive calcium channels (VSCC) and cAMP signaling in goldfish. We further characterized the involvement of Ca2+ in evoked release by PACAP and DA, by examining the sensitivity of evoked GH release to perturbations of Ca2+ signaling. Both VSCC and calmodulin/calmodulin-dependent kinase are involved in PACAP signaling as had been shown for DA.