Predictors of cognitive dysfunction after major noncardiac surgery.

Background: The authors designed a prospective longitudinal study to investigate the hypothesis that advancing age is a risk factor for postoperative cognitive dysfunction (POCD) after major noncardiac surgery and the impact of POCD on mortality in the first year after surgery.

Methods: One thousand sixty-four patients aged 18 yr or older completed neuropsychological tests before surgery, at hospital discharge, and 3 months after surgery. Patients were categorized as young (18-39 yr), middle-aged (40-59 yr), or elderly (60 yr or older).

An integrated coronary circulation teaching model.

Objectives: We present in this paper a model of the coronary circulation. This model is integrated with a model of the systemic circulation, and contains models for oxygen supply and demand.

Methods: Three compartments are created: one for the right ventricle, one for the epicardial segment of the left ventricle and one for the endo-cardial segment of the left ventricle.

Learning about new anesthetics using a model driven, full human simulator.

Objective: New pharmacological agents are introduced into medical practice at an ever-increasing pace. Teaching how to use new medications in the clinical setting presents educational challenges and puts patients at risk.

Methods: Patients and clinical settings in which remifentanil might provide clinical advantages over existing anesthetics were identified.

Safety in anesthesia.

The specialty of anesthesiology has made extraordinary advances in anesthesia safety. Yet, anesthetic mortality and morbidity continue to be far from tolerable. Efforts to enhance safety in anesthesia must include adherence to explicit and implicit safety standards, must make use of equipment that offers modern safety features, must seek to detect and correct developing safety threats as early as possible and must have a structured system to analyze problems and to institute remedies to prevent their recurrence.