Enhancing patient participation in discharge medication communication: a feasibility pilot trial.

Objectives: To pilot test a co-designed intervention that enhances patient participation in hospital discharge medication communication.

Design: Pilot randomised controlled trial.

Setting: One tertiary hospital.

Co-design of an intervention to improve patient participation in discharge medication communication.

Patients can experience medication-related harm and hospital readmission because they do not understand or adhere to post-hospital medication instructions. Increasing patient medication literacy and, in turn, participation in medication conversations could be a solution. The purposes of this study were to co-design and test an intervention to enhance patient participation in hospital discharge medication communication.

Asystole During Elective Cervical Spine Surgery: A Case Study.

A 52-year-old, ASA class II patient was scheduled for anterior cervical discectomy and fusion at the C3 - C4 level. During the surgery when the surgeon was placing retractors the patient developed an instant onset of asystole. This case review will discuss potential reasons for asystole during cervical spinal surgery, as well as anatomical considerations when confronted with asystole during surgical dissection and retraction.

Nursing Care During Lidocaine Infusion Therapy for Chronic Pain.

Pain is a universal event, and perianesthesia nurses provide a pivotal role in the assessment, treatment, and management of the physical and emotional responses to pain. Chronic neuropathic pain is particularly resistant to treatment, and patients often present after many failed therapies with multiple co-morbidities and complex medication histories. With more and more perianesthesia nurses involved with chronic pain management, it is imperative they understand the special nursing care needs of patients receiving intravenous lidocaine infusion therapy.

Anesthesia Machine Failure: A Case Study.

This article examines successful management of an anesthesia machine failure with the Draeger (or Dräger) Apollo (Draeger Inc) anesthesia workstation. Approximately 45 minutes into the case, while the patient was under general anesthesia and mechanical ventilation, the anesthesia machine failed to achieve positive pressurization following a high-pressure alarm. Despite multiple maneuvers, the issue did not resolve until the machine was manually powered off and on at the main power switch.

Upper limb dimensions in adults presenting for elective surgery - implications for blood pressure measurement.

Background: Arm conicity is associated with non-invasive blood pressure (NIBP) measurement error and may be avoided by using finger cuffs. Predicting arm conicity may help decisions regarding NIBP measurement techniques.

Methods: We obtained upper limb measurements of adults presenting to the Pre-Anesthetic Clinic to determine: the suitability of arm and finger cuff sizes; the best anthropometric predictor of arm conicity based on the right arm slant angle; the incidence of a right arm slant angle < 83 degrees.

Intravenous Lidocaine for Relief of Chronic Neuropathic Pain.

The purpose of this study was to describe the therapeutic effectiveness/pain relief of moderate-dose lidocaine infusions in patients with chronic neuropathic pain. Retrospective reviews of medical records were conducted for 40 patients referred to a midwestern pain clinic for management of intractable neuropathic pain despite use of multiple medications and treatment modalities. Descriptive statistics were used to summarize patients' demographic data, lidocaine dosing and infusion rate, daily opioid intake, adjuvant medication use, and medication allergies and intolerances.

Intravenous Lidocaine for Chronic Neuropathic Pain A Systematic Review Addressing Nursing Care.

Background: The intravenous administration of lidocaine for patients with chronic neuropathic pain is well documented in the literature. However, little is known about the role of the nurse caring for patients receiving the infusion.

Aim: The purpose of this systematic review was to examine and describe common side effects associated with the intravenous administration of lidocaine to patients with chronic neuropathic pain and outline nursing care described in an effort to develop evidence-based protocols for care.

Knee osteoarthritis has doubled in prevalence since the mid-20th century.

Knee osteoarthritis (OA) is believed to be highly prevalent today because of recent increases in life expectancy and body mass index (BMI), but this assumption has not been tested using long-term historical or evolutionary data. We analyzed long-term trends in knee OA prevalence in the United States using cadaver-derived skeletons of people aged ≥50 y whose BMI at death was documented and who lived during the early industrial era (1800s to early 1900s; = 1,581) and the modern postindustrial era (late 1900s to early 2000s; = 819). Knee OA among individuals estimated to be ≥50 y old was also assessed in archeologically derived skeletons of prehistoric hunter-gatherers and early farmers (6000-300 B.

A differential cargo-loading model of ciliary length regulation by IFT.

Background: During the assembly and maintenance of cilia, precursor proteins need to be transported from the cell body into the organelle. Intraflagellar transport (IFT) is assumed to be the predominant protein transport pathway in cilia, but it remains largely unknown how ciliary proteins use IFT to reach their destination sites in the cilium and whether the amount of cargo transported by IFT is regulated.

Results: Single-particle imaging showed that DRC4, a structural protein of the axoneme, moves in association with IFT particles inside Chlamydomonas reinhardtii cilia.

From highly enantioselective catalytic reaction of 1,3-diynes with aldehydes to facile asymmetric synthesis of polycyclic compounds.

(S)-1,1'-Binaphth-2-ol (BINOL) in combination with ZnEt(2), Ti(O(i)Pr)(4), and biscyclohexylamine was found to catalyze the highly enantioselective (83-95% ee) addition of various 1,3-diynes to aldehydes of diverse structures. This method provides a convenient pathway to generate a number of optically active dienediynes as the acyclic precursors to polycyclic compounds. The chiral dienediynes undergo highly chemoselective Pauson-Khand (PK) cycloaddition in benzaldehyde by using [Rh(cod)Cl](2) as the catalyst in the presence of rac-BINAP.

Asystole during laryngoscopy of a patient with pleural and pericardial effusions: a case report.

A 53-year-old woman presented to the operating room for surgical correction of pericardial and pleural effusions. Her history included stage IV breast cancer, well-controlled hypertension, and diverticulitis. Although her baseline blood pressure, heart rate, and respirations were normal, she was short of breath with diminished breath sounds on the left side of the lungs and required oxygen, 2 L/min via nasal cannula.

Awareness under anesthesia.

Awareness under anesthesia, also known as unintentional intraoperative awareness, occurs when a patient unintentionally becomes aware while under general anesthesia. Although unintentional intraoperative awareness occurs rarely, patients who experience this may develop anxiety disorders of varying severity, including posttraumatic stress disorder. Perianesthesia nurses can play an important role in the prevention and management of unintentional intraoperative awareness in patients.

Geriatric anesthesia implications.

The geriatric patient will continue to pose challenges during the perianesthesia period. By age 80, the older adult has experienced many physiological and anatomical changes, many starting during the 4th decade of life. Changes in tissue mass and function in major organ systems demand special perianesthetic care planning to optimize patient outcomes.

Influence of prolonged intermittent high-intensity exercise on knee flexor strength in male and female soccer players.

This study investigated the effect of an acute, prolonged, intermittent, high-intensity single-leg pedalling exercise task (PIHIET) on the isokinetic leg strength of the knee flexors in six male and seven female collegiate soccer players. Following determination of single-leg VO(2peak), subjects completed a PIHIET designed to simulate the energetics of soccer match play (approximately 90 min in total; approximately 70% single-leg VO(2peak)). Pre-, mid- and post-PIHIET gravity-corrected indices of knee flexion peak torque (PT) and range of motion-relativised torque at 15% of knee flexion (RRT(15%); 0% = full knee extension) were assessed at a lever-arm angular velocity of 1.

Use of complementary and alternative medications by surgical patients.

Complementary and alternative medication (CAM) use is increasing in popularity across the United States. Not surprisingly, health care providers' encounters with patients who use these medications are increasing as well. The manufacturing and production of CAM are not strictly regulated in contrast to prescription and other over-the-counter medications.

Learning from a nurse anesthetist perspective: a qualitative study.

This study explored the learning and problem-solving experiences of Certified Registered Nurse Anesthetists (CRNAs) using a qualitative case study design. Through interviewing and observation techniques, 5 expert CRNAs provided information on learning and problem solving in daily clinical practice. Data were analyzed using the Tesch 8-step model.

Opioid use during the perianesthesia period: nursing implications.

Opioids are used extensively for pain management during the perianesthesia period. These compounds exhibit varying degrees of agonism and antagonism at mu, kappa, and Delta opioid receptors. Stimulation of these receptors cause similar and distinctive actions such as analgesia, euphoria, dysphoria, and respiratory depression.

Detrimental effects of hypothermia: a systems analysis.

Hypothermia influences body functions in many positive and negative ways. Hypothermia may be purposely induced during neurological or cardiac surgery for its cerebral protectant effects. However, hypothermia during the perioperative period is often detrimental, leading to increased bleeding and blood product utilization, as well as prolonged stays in the PACU.

Limitations to self-care in the ambulatory surgical patient.

Myalgia, or muscle pain, is a common postoperative phenomenon. Causes of myalgia include age, gender, medication, positioning, and abdominal insufflation for laparoscopic surgery. For some patients, myalgia may be more severe than surgically induced pain.