Publications by authors named "Michael O'Rourke"

Purpose Of Review: This article explores the unique intersection of the challenges confronting ambulatory anesthesiology education and charts a trajectory forward. The proportion of ambulatory, nonoperating room (NORA), and office-based surgical cases continues to rise; however, the requirements for trainees in these settings have remained static. The rapid evolution of the field combined with a limited workforce also makes continuing education essential, and we discuss the current and future states of ambulatory anesthesia education.

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Despite institutional efforts, growth in the number of faculty of color has largely plateaued, limiting research innovation and other benefits of diversity. In this article, we seek to understand structural barriers to faculty equity by (a) detailing a theory of epistemic exclusion within academia and (b) applying the theory of epistemic exclusion to the specific context of faculty departmental reviews of scholarly research (e.g.

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Article Synopsis
  • * Results showed a reduction in mean LOS by nearly 4 days for patients with negative test results, without impacting overall patient acuity or systemwide LOS.
  • * The financial analysis indicated an estimated total savings of $3.9 million, translating to an average of $7,305 saved per patient, despite rising healthcare costs.
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Objectives: Photodynamic therapy (PDT) is a vaso-occlusive treatment for a number of chorioretinal vascular pathologies. We aimed to retrospectively analyse efficiency and safety of PDT for different conditions (central serous retinopathy (CSR), age-related macular degeneration (AMD), macular telangiectasia type 2 and choroidal hemangioma) and with different verteporfin parameters.

Methods: Clinical parameters were ascertained from the medical records of patients undergoing PDT over a 6-year period.

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Introduction: Dedicated perioperative care can be cost-effective and improve patient outcomes. Training future physicians to practice perioperative medicine is an important responsibility of medical educators. An e-learning module delivered asynchronously during clinical rotations in perioperative medicine may help to better satisfy this responsibility.

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Article Synopsis
  • The Society for Ambulatory Anesthesia (SAMBA) analyzed the effectiveness of pectoralis (PECS) blocks for breast surgery analgesia and compared it with other methods like systemic analgesia and paravertebral blockade.
  • PECS blocks were found to moderately reduce opioid use, prolong the time before additional pain relief is needed, and lower postoperative pain scores compared to systemic analgesics.
  • SAMBA recommends PECS blocks for breast-conserving surgery when systemic analgesia isn't used, but it doesn’t strongly favor PECS over local infiltration; for mastectomy, PECS can be as effective as paravertebral blocks if the latter isn't an option.
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Objectives: Arterial stiffness is widely accepted as an important predictor of cardiovascular disease (CVD) development. While obesity is generally associated with increased CVD risk, there is evidence that overweight patients with existing CVD may have better clinical outcomes than their lean counterparts. Our study sought to observe any potential association between brachial−ankle pulse wave velocity (BAPWV), a marker of arterial stiffness related to CVD risk, and Body Mass Index (BMI), a crude and widely used measure of obesity.

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Background/objectives: The US Food and Drug Administration (FDA) is responsible for assessing safety (risks) and effectiveness (benefits) of new drug products using the data provided in a Sponsor's new drug product marketing application before they can be marketed. The FDA forms cross-disciplinary review teams to conduct these assessments. Recently, the FDA began implementing more interdisciplinary approaches to its assessments, reducing redundancy in review processes and documentation by increasing team integration around review issues.

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Purpose: We present a retrospective case series on the use of Hughes flap in managing acquired cicatricial lower lid retraction.

Methods: This was a multicentre, retrospective case series. Data was collected from medical records across different sites within Australia (Adelaide, Melbourne, and Sydney) and New Zealand (Hamilton).

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Background: The use of wearable cuffless blood pressure (BP) devices is becoming commercially prevalent with little published validation information. Most devices rely, at least in part, on the relationship between pulse arrival time (PAT) and BP, a theoretical fundamental relationship that was first commercially exploited in 1993 with the release of the Casio BP-100 digital watch.

Objective: This study explored the PAT method of BP estimation in a commercial device where it first began, the Casio BP-100 (Model No.

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Introduction: This study was undertaken with an aim to identify any common factors or trends among patients of orbital cellulitis that developed neurological complications.

Methods: A 24-month retrospective review of patients was undertaken to include those showing clinical deterioration and neurological complications on radiological imaging, after being treated for orbital cellulitis at Manchester Royal Eye Hospital. The study specifically looked at the site of orbital collection, sinus involvement, types of neurological complications and whether these were detected at initial presentation, surgical input and microbiology findings.

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Background And Objectives: While there are several published recommendations and guidelines for trainees undertaking subspecialty Fellowships in regional anesthesia, a similar document describing a core regional anesthesia curriculum for non-fellowship trainees is less well defined. We aimed to produce an international consensus for the training and teaching of regional anesthesia that is applicable for the majority of worldwide anesthesiologists.

Methods: This anonymous, electronic Delphi study was conducted over two rounds and distributed to current and immediate past (within 5 years) directors of regional anesthesia training worldwide.

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There is a lack of guidelines for preoperative dosing of opioid and nonopioid pain medications for surgical patients, which can lead to suboptimal preoperative pain control. The Society for Perioperative Assessment and Quality Improvement identified preoperative dosing of opioid and nonopioid analgesics as an area in which consensus could improve patient care. The aim of this guideline is to provide consensus that will allow perioperative physicians to make optimal recommendations regarding preoperative pain medication dosing.

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Introduction: Ventricular function in elderly patients with aortic stenosis is impeded both by restricted aortic flow and arterial stiffening. A number of patients continue to have exertional intolerance after relief of aortic valvular obstruction due to unrecognized ventriculo-arterial coupling mismatch.

Hypothesis: Quantification of valvulo-arterial load (VAL), using a simultaneous applanation tonometry/cardiac magnetic resonance (CMR) technique, can accurately assess the relative contributions of aortic stiffness and valve gradient in older patients with aortic stenosis.

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Purpose: Bleb dysfunction may occur as a late complication following glaucoma filtration surgery. Over-filtering, thinning and cystic blebs can lead to hypotony, leak and corneal dellen. We report our surgical management and outcomes of this specific entity using donor scleral patch grafts.

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Purpose: Optimal assessment of cardiovascular performance requires simultaneous measurement of load independent left ventricular (LV) contractility, arterial function and LV/arterial coupling. We aimed to demonstrate feasibility of non-invasive ventricular pressure-volume and aortic pressure-flow-impedance measurements using simultaneous arterial tonometry (AT) and cardiovascular magnetic resonance imaging (CMRI).

Methods: 21 consecutive patients referred for CMRI were enrolled to undergo a simultaneous AT and CMRI protocol.

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Despite multiple studies, it has not been possible to account for the normal changes of blood pressure that occur from infancy to old age. We sought a comprehensive explanation, by linking brachial pressure with the well documented changes in the arterial pulse waveform, whose peak and nadir determine systolic, diastolic and pulse pressure in brachial arteries. Changes in humans arterial pulse wave contour from birth to old age can be readily explained on (i) growth, with increasing length of the body from birth to adolescence, and adult height maintained thereafter, and (ii) degeneration and dilation of the aorta from elastic fibre fracture throughout life, causing progressive increase in aortic pressure wave amplitude from early return of wave reflection, and summation of incident with reflected waves in systole.

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