Evaluating the utility of fasting lipid panel in addition to random lipid panel in determining lipid-lowering therapy in acute ischemic stroke or TIA patients.

Background: Hyperlipidemia is one of the major risk factors for cerebrovascular disease and it is common practice to obtain fasting lipid profile prior to starting lipid lowering therapy (LLT). Recent AHA Guidelines published in 2018 allow for a non-fasting value to be used.

Objective: To determine if obtaining fasting lipid levels in addition to random lipid levels prompts changes in hyperlipidemia management of acute stroke patients.

Transcutaneous CO versus end-tidal CO in neonates and infants undergoing surgery: a prospective study.

End-tidal CO (Et) is the standard in operative care along with pulse oximetry for ventilation assessment. It is known to be less accurate in the infant population than in adults. Many neonatal intensive care units (NICU) have converted to utilizing transcutaneous CO (tcP) monitoring.

An exploratory study of the relationship between postoperative nausea and vomiting and postdischarge nausea and vomiting in children undergoing ambulatory surgery.

Background: The factors contributing to postoperative nausea and vomiting in children have been identified, but there have been no reported studies that have studied pediatric postdischarge nausea and vomiting.

Aims: This preliminary study aimed to identify  the factors affecting postdischarge nausea and vomiting in ambulatory children, specifically whether postoperative nausea and vomiting factors are contributory.

Methods: One hundred and twenty-two pediatric patients aged 5-10 years undergoing elective ambulatory surgery participated in this institution-approved study.

Preoperative Screening for Obstructive Sleep Apnea and Outcomes in PACU.

Purpose: Practice guidelines from the perianesthesia community suggest that preoperative identification of patients with obstructive sleep apnea (OSA) and standardized longer observation in postanesthesia care unit (PACU) promotes safety after general anesthesia. The purpose of this study was to determine if longer monitoring of patients with OSA in the PACU improves patient outcomes after general anesthesia.

Design: Evidence-based best practices literature review.

Intrathecal morphine administration reduces postoperative pain and peripheral endocannabinoid levels in total knee arthroplasty patients: a randomized clinical trial.

Background: The primary goal of this study was to determine whether administration of intrathecal morphine reduces postoperative pain. The secondary goal was to determine the effect of intrathecal morphine upon circulating levels of the weakly analgesic endocannabinoids, anandamide (AEA) and 2-arachidonoylglycerol (2-AG), and the related lipids palmitoylethanolamide (PEA) and oleoylethanolamide (OEA).

Methods: Forty two total knee arthroplasty (TKA) patients were enrolled in a prospective, double-blinded, randomized study.

Interleukin-6 and leptin levels are associated with preoperative pain severity in patients with osteoarthritis but not with acute pain after total knee arthroplasty.

Background: Identifying drivers of pain that can serve as novel drug targets is important for improving perioperative analgesia. Total knee arthroplasty (TKA) is associated with significant postoperative pain. Cytokines contribute to the pathophysiology of osteoarthritis (OA) and associated pain.

Career Development Guidance and Mentorship during Anesthesia Residency Training: An Internet Survey.

Background: We conducted a survey of Anesthesiology residency programs in the United States to identify current practice regarding mentorship and teaching of topics related to career development.

Methods: Program directors for all currently accredited Anesthesiology residency programs (N=129 as of April 2016) were contacted by e-mail and invited to complete a short internet survey. Two follow-up e-mails were sent at one-week intervals to those who had not yet responded.

Sleep problems in breast cancer survivors 1-10 years posttreatment.

Unlabelled: ABSTRACTObjective:Sleep can affect quality of life (QoL) during cancer survivorship, and symptoms related to poor sleep can be exacerbated. We examined the prevalence, severity, and nature of subjective sleep complaints in women surviving stage I-III breast cancer who were 1-10 years posttreatment. We also examined the demographic, medical, physical, and psychosocial correlates of poor sleep in these women in order to identify the subgroups that may be most in need of intervention.

Polysomnographic Study of Sleep in Survivors of Breast Cancer.

Study Objective: Insomnia is a frequent complaint in breast cancer patients during and after treatment. Breast cancer survivors, 1-10 years posttreatment, underwent in-lab polysomnography (PSG) to objectively define the insomnia in those patients with such a complaint.

Methods: Twenty-six breast cancer survivors (aged 39-80, mean 54.

Leptin levels are negatively correlated with 2-arachidonoylglycerol in the cerebrospinal fluid of patients with osteoarthritis.

Background: There is compelling evidence in humans that peripheral endocannabinoid signaling is disrupted in obesity. However, little is known about the corresponding central signaling. Here, we have investigated the relationship between gender, leptin, body mass index (BMI) and levels of the endocannabinoids anandamide (AEA) and 2-arachidonoylglycerol (2-AG) in the serum and cerebrospinal fluid (CSF) of primarily overweight to obese patients with osteoarthritis.

Endocannabinoids and acute pain after total knee arthroplasty.

Osteoarthritis (OA) of the knee is a progressive disease that is associated with inflammation of the joints and lower extremity pain. Total knee arthroplasty (TKA) is a surgical procedure that aims to reduce pain and restore motor function in patients suffering from OA. The immediate postoperative period can be intensely painful leading to extended recovery times including persistent pain.

A survey on teaching ultrasound-guided chronic pain procedures in pain medicine fellowship programs.

Background: Over the last decade ultrasound guidance (USG) has been utilized very successfully in acute pain procedures to confirm nerves' anatomic location and obtain live images. Not only the utilization, but the teaching, of USG has become an essential part of anesthesiology residency training. Prior to the introduction of USG, chronic pain procedures were always done either under fluoroscopy or blindly.

Metabolomic profiling of children's brains undergoing general anesthesia with sevoflurane and propofol.

Background: We recently applied proton magnetic resonance spectroscopy (HMRS) to investigate metabolic consequences of general anesthesia in the rodent brain, and discovered that isoflurane anesthesia was characterized by higher concentrations of lactate, glutamate, and glucose in comparison with propofol. We hypothesized that the metabolomic differences between an inhalant and intravenous anesthetic observed in the rodent brain could be reproduced in the human brain.

Methods: HMRS-based metabolomic profiling was applied to characterize the cerebral metabolic status of 59 children undergoing magnetic resonance imaging during anesthesia with either sevoflurane or propofol.

Brain metabolomic profiles of lung cancer patients prior to treatment characterized by proton magnetic resonance spectroscopy.

Cancer patients without evidence of brain metastases often exhibit constitutional symptoms, cognitive dysfunction and mood changes at the time of clinical diagnosis, i.e. prior to surgical and/or chemotherapy treatment.

Visual P2-N2 complex and arousal at the time of encoding predict the time domain characteristics of amnesia for multiple intravenous anesthetic drugs in humans.

Background: Intravenous anesthetics have marked effects on memory function, even at subclinical concentrations. Fundamental questions remain in characterizing anesthetic amnesia and identifying affected system-level processes. The authors applied a mathematical model to evaluate time-domain components of anesthetic amnesia in human subjects.

Propofol and midazolam inhibit conscious memory processes very soon after encoding: an event-related potential study of familiarity and recollection in volunteers.

Background: Intravenous drugs active via gamma-aminobutyric acid receptors to produce memory impairment during conscious sedation. Memory function was assessed using event-related potentials (ERPs) while drug was present.

Methods: The continuous recognition task measured recognition of photographs from working (6 s) and long-term (27 s) memory while ERPs were recorded from Cz (familiarity recognition) and Pz electrodes (recollection recognition).

Low-dose propofol-induced amnesia is not due to a failure of encoding: left inferior prefrontal cortex is still active.

Background: Propofol may produce amnesia by affecting encoding. The hypothesis that propofol weakens encoding was tested by measuring regional cerebral blood flow during verbal encoding.

Methods: Seventeen volunteer participants (12 men; aged 30.

Propofol and thiopental do not interfere with regional cerebral blood flow response at sedative concentrations.

Background: Anesthetics may affect the regional cerebral blood flow (rCBF) response associated with increased brain activity in humans. rCBF was measured as auditory stimulus rate was increased during propofol and thiopental administration.

Methods: After informed consent, 10 right-handed male volunteer participants (aged 33.

Information loss over time defines the memory defect of propofol: a comparative response with thiopental and dexmedetomidine.

Background: Sedative-hypnotic drugs impair memory, but details regarding the nature of this effect are unknown. The influences of propofol, thiopental, and dexmedetomidine on the performance of a task that isolates specific components of episodic memory function were measured.

Methods: Working (1 intervening item, 6 s) and long-term memory (10 intervening items, 33 s) were tested using auditory words in a continuous recognition task before and during drug administration.

Propofol-induced alpha rhythm.

The electroencephalographic effects of two intravenous sedative/hypnotic drugs, propofol and thiopental, were studied at three stable blood concentrations in 52 normal healthy volunteers. The higher concentration resulted in unresponsiveness (lack of response to auditory/tactile stimuli) in all subjects. This report describes the strong frontal-central rhythms apparent in this state using a quantitative description of oscillatory systems underlying the rhythm.

A neuroanatomical construct for the amnesic effects of propofol.

Background: This study was designed to identify neuroanatomical locations of propofol's effects on episodic memory by producing minimal and maximal memory impairment during conscious sedation. Drug-related changes in regional cerebral blood flow (rCBF) were located in comparison with rCBF increases during a simple word memory task.

Methods: Regional cerebral blood flow changes were assessed in 11 healthy volunteers using H215O positron emission tomography (PET) and statistical parametric mapping (SPM99) at 600 and 1,000 ng/ml propofol target concentrations.

Midazolam decreases cerebral blood flow in the left prefrontal cortex in a dose-dependent fashion.

Midazolam, a short-lived benzodiazepine producing sedation and reversible anterograde amnesia, was administered intravenously to 14 healthy male volunteers. Regional cerebral blood flow (rCBF) was measured using positron emission tomography (PET) with intravenous H2 15O at either a 'high' midazolam EEG effect (EEG signs of stage 2 sleep), or 'low' midazolam EEG effect (increase in EEG beta power only). Memory tests administered following PET scans showed significant drug-induced impairment in learning and retrieval at the same drug concentration at which PET images were acquired.