Formation of an Airway Lead Network: an essential patient safety initiative.

We outline the history, implementation and clinical impact of the formation of an Airway Lead Network. Although recommendations to improve patient safety in airway management are published and revised regularly, uniform implementation of such guidelines are applied sporadically throughout the hospital and prehospital settings. The primary roles of an Airway Lead are to ensure supply, quality and storage of airway equipment, promote the use of current practice guidelines as well as the organisation of training and audits.

Patient-Centered Perioperative Care for a Victim of Military Sexual Trauma.

Introduction: The patient population seen in our nation's Veterans Affairs Healthcare system is increasingly female and an alarming percentage of our veterans, male and female alike, report a history of military sexual trauma (MST), which is associated with an increased burden of morbidities including post-traumatic stress disorder (PTSD) and substance abuse. The experience of surgery can produce symptoms of PTSD in a clinically significant percentage of patients. This article describes the challenges of achieving a patient-centered perioperative care plan in the case of a female veteran who suffers from PTSD as a result of MST.

What We All Should Know About Our Patient's Airway: Difficult Airway Communications, Database Registries, and Reporting Systems Registries.

Documentation and dissemination of patient information characterizing a difficult airway encounter is a critical safety link between past, present, and future health care providers. Effective communication of the nature of the difficulty encountered and the airway management techniques used consists of documentation in the patient's medical record for concurrent care providers and dissemination of that information to the patient and future providers for use during subsequent episodes of care. Significant progress has been made with developing national and international electronic patient record systems and airway databases, but full integration has yet to be achieved.

Preoperative depression symptom severity and its impact on adherence to preoperative beta-blocker therapy.

Objectives: To test the association among depression symptoms, distressed personality type, and preoperative beta-blocker nonadherence and to estimate the prevalence of untreated major depression in this population.

Design: Prospective observational study.

Setting: A veterans hospital.

Summary of the panel session at the 38th Annual Surgical Symposium of the Association of VA Surgeons: what is the big deal about frailty?

Owing to the phenomenon known as "global graying," elderly-specific conditions, including frailty, will become more prominent among patients undergoing surgery. The concept of frailty, its effect on surgical outcomes, and its assessment and management were discussed during the 38th Annual Surgical Symposium of the Association of VA Surgeons panel session entitled "What's the Big Deal about Frailty?" and held in New Haven, Connecticut, on April 7, 2014. The expert panel discussed the following questions and topics: (1) Why is frailty so important? (2) How do we identify the frail patient prior to the operating room? (3) The current state of the art: preoperative frail evaluation.

Atenolol is associated with lower day-of-surgery heart rate compared to long- and short-acting metoprolol.

Objectives: The authors analyzed the association between outpatient β-blocker type and day-of-surgery (DOS) heart rate in ambulatory surgical patients. They further investigated whether differences in DOS heart rate between atenolol and metoprolol could be explained by once-daily versus twice-daily dosing regimens.

Design: Retrospective observational study.

β-blocker withdrawal among patients presenting for surgery from home.

Objective: This study sought to measure the prevalence of perioperative β-blocker noncompliance by patients who were prescribed long-term β-blocker therapy and presented for surgery from home. The effect of patient noncompliance on the presenting heart rate on the day of surgery also was examined.

Design: Prospective observational study with outcome data obtained from reviews of medical records.

Intravenous dextrose administration reduces postoperative antiemetic rescue treatment requirements and postanesthesia care unit length of stay.

Background: Postoperative nausea and vomiting (PONV) remains the most common postoperative complication, and causes decreased patient satisfaction, prolonged postoperative hospital stays, and unanticipated admission. There are limited data that indicate that dextrose may reduce nausea and vomiting. In this trial, we attempted to determine whether the rate of PONV can be decreased by postoperative administration of IV dextrose bolus.

Netrins and neogenin promote myotube formation.

Differentiation of skeletal myoblasts into multinucleated myotubes is a multistep process orchestrated by several families of transcription factors, including myogenic bHLH and NFAT proteins. The activities of these factors and formation of myotubes are regulated by signal transduction pathways, but few extracellular factors that might initiate such signals have been identified. One exception is a cell surface complex containing promyogenic Ig superfamily members (CDO and BOC) and cadherins.

Promyogenic members of the Ig and cadherin families associate to positively regulate differentiation.

Determination and differentiation of cells in the skeletal muscle lineage is positively regulated by cell-cell contact. Cell-surface proteins proposed to mediate this effect include both classical cadherins and Ig superfamily members; potential interactions between the promyogenic activities of these classes of protein, however, are unknown. We show here that CDO and BOC, two promyogenic Ig superfamily members that bind to each other in a cis fashion, form complexes with N- and M-cadherin.