Ethics and Management of Substance Use Disorders in Anesthesiology: Detection, Intervention, and Treatment Through Recovery and Return.

Prevention, detection, intervention, treatment, and recovery from substance use disorders (SUDs) in anesthesiology must include adherence to the 4 principles of bioethics. Impaired physicians must be afforded autonomy to the extent appropriate while also ensuring that no patient is harmed, or care compromised. Departments and health systems must also avoid causing further harm to the physician suffering from an SUD.

A second chance for a new heart? The role of metabolic and bariatric surgery in patients with end-stage heart failure.

Background: Obesity is an independent risk factor for heart failure (HF). Substantial weight loss has been shown to reverse obesity-related cardiomyopathy. This study aimed to report our institution's experience with laparoscopic sleeve gastrectomy (LSG) in patients with morbid obesity and end-stage HF.

Vasoplegic syndrome during heart transplantation: A systematic review and meta-analysis.

Background: Vasoplegic syndrome (VS) is a common occurrence during heart transplantation (HT). It currently lacks a uniform definition between transplant centers, and its pathophysiology and treatment remain enigmatic. This systematic review summarizes the available published clinical data regarding VS during HT.

An open-source platform for pediatric cancer data exploration: a report from Data for the Common Good.

Objective: The Pediatric Cancer Data Commons (PCDC)-a project of Data for the Common Good-houses clinical pediatric oncology data and utilizes the open-source Gen3 platform. To meet the needs of end users, the PCDC development team expanded the out-of-box functionality and developed additional custom features that should be useful to any group developing similar data commons.

Materials And Methods: Modifications of the PCDC data portal software were implemented to facilitate desired functionality.

Evaluating the Impact of Operative Team Familiarity on Cardiac Surgery Outcomes: A Retrospective Cohort Study of Medicare Beneficiaries.

Objective: To associate surgeon-anesthesiologist team familiarity (TF) with cardiac surgery outcomes.

Background: TF, a measure of repeated team member collaborations, has been associated with improved operative efficiency; however, examination of its relationship to clinical outcomes has been limited.

Methods: This retrospective cohort study included Medicare beneficiaries undergoing coronary artery bypass grafting (CABG), surgical aortic valve replacement (SAVR), or both (CABG+SAVR) between January 1, 2017, and September 30, 2018.

Fixed-Bearing Unicompartmental Knee Arthroplasty of the Lateral Compartment: A Series of 246 Cases.

Background: Isolated osteoarthritis of the lateral compartment of the knee is less common than that of the medial compartment, resulting in significantly fewer lateral unicompartmental knee arthroplasties (UKAs) being performed. This study aimed to evaluate results of a fixed-bearing UKA for the treatment of lateral compartment osteoarthritis of the knee.

Methods: A prospectively collected cohort of 255 patients undergoing fixed-bearing UKA of the lateral compartment using the Triathlon PKR (Stryker, Warsaw, IND) implant with a minimum 2-year follow-up was reviewed.

Prevention of drug diversion and substance use disorders among anesthesiologists: a narrative review.

Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering, transmission of disease, as well as the risk associated with impaired vigilance. Healthcare providers may be harmed by the physical and mental impact of their addictions.

Invasive Pressure Monitors: Leveling the Playing Field.

Invasive pressure monitors are ubiquitous in cardiothoracic and vascular anesthesia. This technology allows beat-to-beat assessment of central venous, pulmonary, and arterial blood pressures during surgery, procedural interventions, and critical care. Education is commonly focused on the procedural aspects and the complications associated with the initial placement of these monitors without instruction on the technical concepts required for obtaining accurate data.

Intracardiac thrombosis and pulmonary thromboembolism during liver transplantation: A systematic review and meta-analysis.

Intracardiac thrombosis and/or pulmonary thromboembolism (ICT/PE) is a rare but devastating complication during liver transplantation. Its pathophysiology remains poorly understood, and successful treatment remains a challenge. This systematic review summarizes the available published clinical data regarding ICT/PE during liver transplantation.

Barriers to recovery for medical professionals: Assessing financial support through a survey of Physician Health Programs.

Background And Objectives: There is increasing focus on physician burnout, psychiatric problems, and substance use disorders. Costs of recovery for physicians enrolled in Physician Health Programs (PHPs) remain unexamined with little known regarding funding resources. We sought to elucidate perceived costs of recovery from impairing conditions and highlight resources for financial strain.

GA4GH: International policies and standards for data sharing across genomic research and healthcare.

The Global Alliance for Genomics and Health (GA4GH) aims to accelerate biomedical advances by enabling the responsible sharing of clinical and genomic data through both harmonized data aggregation and federated approaches. The decreasing cost of genomic sequencing (along with other genome-wide molecular assays) and increasing evidence of its clinical utility will soon drive the generation of sequence data from tens of millions of humans, with increasing levels of diversity. In this perspective, we present the GA4GH strategies for addressing the major challenges of this data revolution.

Outcome of high-power short-duration radiofrequency ablation in combination with half-normal saline irrigation for the treatment of atrial fibrillation.

Background: Data regarding the use of high-power short-duration (HPSD) radiofrequency (RF) in combination with half-normal saline irrigation for catheter irrigation are limited.

Objectives: This study investigated the safety and efficacy of using HPSD RF ablation in combination with half-normal saline irrigation for the treatment of AF.

Methods: One hundred consecutive patients with AF underwent RF ablation using HPSD combined with half-normal saline for catheter irrigation.

Does capsular distension and a short period of countertraction improve outcome following manipulation under anesthesia for the treatment of primary adhesive capsulitis of the glenohumeral joint?

Background: Despite the fact that primary adhesive capsulitis of the glenohumeral joint is often considered a self-limiting condition, not all patients make a full recovery. Manipulation under anesthesia (MUA) is performed to forcibly rupture the contracted capsule in a controlled manner. However, the technique, timing, and use of additional injections are often debated.

Drug abuse amongst anesthetists in Brazil: a national survey.

Background: The prevalence of Substance Use Disorders (SUD) and acceptance of drug testing among anesthetists in Brazil has not been determined.

Methods: An internet-based survey was performed to investigate the prevalence of SUD among anesthetists in Brazil, to explore the attitudes of anesthetists regarding whether SUD jeopardizes the health of an impaired provider or their patient, and to determine the provider's perspective regarding acceptance and effectiveness of drug testing to reduce SUD. The questionnaire was distributed via social media.

Factor V Deficiency (Owren's Disease) in a Patient at High Risk for Transfusion-Associated Circulatory Overload and Bleeding During Laser Lead Extraction.

Congenital factor V deficiency is an extremely rare abnormality and may be associated with significant bleeding as a result of trauma or surgery. Perioperative management primarily includes the administration of fresh frozen plasma to replace the deficient clotting factor. Acute administration of multiple blood products is a risk factor for transfusion-associated circulatory overload.

Perioperative Outcomes of Thrombectomy Patients Using Venovenous Bypass and Suction Filtration With General Anesthesia.

Objective: AngioVac (Angiodynamics, Latham, NY) is a novel drainage system that offers a less-invasive approach compared with open surgical thromboembolectomy to remove intracardiac and intravascular thrombotic and embolic material. For this study, the authors' single-center experience with patients undergoing thromboembolectomy using the AngioVac system was reviewed retrospectively to evaluate anesthetic management and postoperative complications.

Design: Retrospective, observational study.

Implantable Cardioverter-Defibrillator Shock Delivered During Electroconvulsive Therapy Despite Magnet Application: A Case Report.

Electroconvulsive therapy (ECT) in a patient with an implantable cardioverter-defibrillator (ICD) presents challenges to anesthesiologists. We encountered a patient who received an inappropriate shock during ECT despite magnet application. The phenomenon provides insight into how ICDs work-how they can inappropriately detect ECT stimulation and how they deliver antitachycardia therapy.