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Angiotensin II (AT) is a potent vasoconstrictor and hypertensive drug that is registered for the treatment of severe hypotension in vasoplegic shock. Growing experience with the use of AT in cardiac surgery allows the first therapeutic algorithms to be created. This paper is a proposal for the use of AT in distributive shock after extracorporeal circulation. [ABSTRACT FROM AUTHOR]

The article presents abstracts of papers from the Australian Society of Anaesthetists 76th National Scientific Congress on October 7-10, 2017 at the Perth Convention and Exhibition Centre, Perth, Western Australia. Topics include an observational study comparing Scalpel-Bougie technique versus Cannula-to-Melker technique for emergency cricothyroidotomy; incidence of facial pressure ulcers in the prone position and post-operative outcome of elective hip and knee joint replacements.

We analysed how long it has taken for papers authored by Scott Reuben, Joachim Boldt and Yoshitaka Fujii to be retracted: investigations into these three anaesthetists have shown much of their research to be unethical or fraudulent. To date, 94% of their combined papers requiring retraction have been retracted; however, only 85% of the retraction notices were compliant with guidelines produced by the Committee on Publication Ethics. We contacted the Editors-in-Chief and/or publishers of all the journals containing articles that had been identified as requiring retraction but had not yet been retracted. In response to our enquiries, 16 articles have since been retracted; we have documented the journals' responses regarding the remaining papers and await further retractions in the future. There is room for improvement in the way that unethical or fraudulent papers are handled by journals and publishers, beyond the identification of the authors' misconduct. [ABSTRACT FROM AUTHOR]

Vegetarians, vegans, bodybuilders, anorexics, drug addicts, depressed, chronic respiratory disease patients, Mister Pickwick, chronic hepatic suffering individuals, transplanted people, and so many more, they are all our patients. For millennia, pain was a major subject for both patients and doctors and modern anaesthesia realized unbelievable progress in managing pre-operative and postoperative care as well as the realization of surgery "per se" [[16]]. Anesthesiologists calculate scores and evaluate patients in pre-operative clinics. [Extracted from the article]

To explore the current status of anesthesia research activity in Japan, we analyzed the number of abstracts presented at the Japanese Society of Anesthesiologists (JSA) annual meetings by several factors including gender, society branches, and subspecialty categories. The number of abstracts at JSA annual meetings has declined sharply since 2016 with no gender gap. A decrease in the neurological field predated the overall decline, but other subspecialty categories showed a similar decline. Although the Tokyo, Tokai-Hokuriku, and Kyushu branches were responsible for more than half of the reduction, the trend was similar among all branches. In a survey regarding academic activities of university hospital residents and faculty, Ph.D. aspirants' rate was only 20–30%. Residents had never presented an abstract at scientific conferences and never published any papers at nearly 40% and 30% of the university hospitals, respectively. Our survey suggests that junior anesthetists are losing interest in research. Senior faculty and mentors must redouble efforts to embed and encourage research in departments and by anesthetists in training. If a revival of anesthesia research in Japan does not occur then a service only specialty awaits. [ABSTRACT FROM AUTHOR]

The article discusses the 21st anniversary of the Anaesthesia and Intensive Care Jeanette Thirlwell Best Paper Award. It mentions that inaugural Anaesthesia and Intensive Care Junior Investigator Award for 2017 has been awarded to Leigh White of the School of Medicine, University of Wollongong. It also reveals that editorial board of the journal appoints a selection committee of three of its members to adjudicate on the best paper.

Background: International guidelines recommend preoperative multidisciplinary team (MDT) assessment for high-risk surgical patients. Preoperative MDT meetings can help to improve surgical care, but there is little evidence on whether they improve patient outcomes. Methods: This paper aims to share our experience of MDT meetings for high-risk surgical patients to underline their added value to the current standard of care. An observational study of a retrospective cohort of preoperative high-risk MDT meetings of a tertiary referral hospital between January 2015 and December 2020. For 249 patients the outcomes preoperative data, MDT decisions, and patient outcomes were collected from electronic health records. Main results: A total of 249 patients were discussed at high-risk MDT meetings. Most of the patients (97%) were assessed as having an American Society of Anesthesiology score ≥ 3, and 219 (88%) had a European Society of Cardiology and European Society of Anaesthesiology risk score of intermediate or high. After MDT assessment, 154 (62%) were directly approved for surgery, and 39 (16%) were considered ineligible for surgery. The remaining 56 (23%) patients underwent additional assessments before reconsideration at a high-risk MDT meeting. The main reason for patients being discussed at the high-risk MDT meeting was to assess the risk-benefit ratio of surgery. Ultimately, 184 (74%) patients underwent surgery. Of the operated patients, 122 (66%) did not have a major complication in the postoperative period, and 149 patients (81%) were alive after one year. Conclusions: This cohort study shows the vulnerability and complexity of high-risk patients but also shows that the use of an MDT assessment contributes too improved peri- and postoperative treatment strategies in high-risk patients. Most patients underwent surgery after careful risk assessment and, if deemed necessary, preoperative and perioperative treatment optimization to reduce their risk. [ABSTRACT FROM AUTHOR]

Background: In accordance with the focus on patient safety and quality in healthcare, continuing professional development (CPD) has received increasing levels of attention as a means to ensure physicians maintain their clinical competencies and are fit to practice. There is some evidence of a beneficial effect of CPD, though few studies have evaluated its effect within anesthesia. The primary aim of this systematic review was to establish which CPD activities anesthetists are engaged in and their effectiveness. The secondary aim was to explore which methods are employed to evaluate anesthetists' clinical performance. Methods: Databases searched: Medline, Embase and Web of Science, in May 2023. Additional papers were identified through searching the references of included studies. Eligible studies included anesthetists, either exclusively or combined with other healthcare professionals, who underwent a learning activity or assessment method as part of a formalized CPD program or a stand‐alone activity. Non‐English language studies, non‐peer reviewed studies and studies published prior to 2000 were excluded. Eligible studies were quality assessed and narratively synthesized, with results presented as descriptive summaries. Results: A total of 2112 studies were identified, of which 63 were eligible for inclusion, encompassing more than 137,518 participants. Studies were primarily of quantitative design and medium quality. Forty‐one studies reported outcomes of single learning activities, whilst 12 studies investigated different roles of assessment methods in CPD and ten studies evaluated CPD programs or combined CPD activities. A 36 of the 41 studies reported positive effects of single learning activities. Investigations of assessment methods revealed evidence of inadequate performance amongst anesthetists and a mixed effect of feedback. Positive attitudes and high levels of engagement were identified for CPD programs, with some evidence of a positive impact on patient/organizational outcomes. Discussion: Anesthetists are engaged in a variety of CPD activities, with evidence of high levels of satisfaction and a positive learning effect. However, the impact on clinical practice and patient outcomes remains unclear and the role of assessment is less well‐defined. There is a need for further, high‐quality studies, evaluating a broader range of outcomes, in order to identify which methods are most effective to train and assess specialists in anesthesia. [ABSTRACT FROM AUTHOR]

Aims: To identify and synthesize the evidence regarding the facilitators and barriers relating to birthing pool use from organizational and multi-professional perspectives. Design: A systematic integrated mixed methods review was conducted. Data sources: MEDLINE, CINAHL, PsychINFO, EMCARE, PROQUEST and Web of Science databases were searched in April 2021, March 2022 and April 2024. We cross-referenced with Google Scholar and undertook reference list searches. Review methods: Data were extracted from studies meeting the inclusion criteria. Barriers and facilitators to birthing pool use were mapped and integrated into descriptive statements further synthesized to develop overarching themes. Results: Thirty seven articles (29 studies) were included—quantitative (12), qualitative (8), mixed methods (7), and audits (2), from 12 countries. These included the views of 9,082 multi-professionals (midwives, nurses, obstetricians, neonatologists, students, physicians, maternity support workers, doulas and childbirth educators). Additionally, 285 institutional policies or guidelines were included over 9 papers and 1 economic evaluation. Five themes were generated: The paradox of prescriptiveness, The experienced but elusive practitioner, Advocacy and tensions, Trust or Trepidation and It's your choice, but only if it is a choice. These revealed when personal, contextual, and infrastructural factors were aligned and directed towards the support of birth pool use, birthing pool use was a genuine option. Conversely, the more barriers that women and midwives experienced, the less likely it was a viable option, reducing choice and access to safe analgesia. Conclusion: The findings demonstrated a paradoxical reality of water immersion with each of the five themes detailing how the "swing" within these factors directly affected whether birthing pool use was facilitated or inhibited. Plain English Summary: During childbirth, most women wish to use a pain management technique; some prefer to use medications and others prefer non-medication methods. Another option is to use a birthing pool, larger than a typical bath, that encourages buoyancy and the freedom to move. The warm water can also offer comfort, relaxation and pain relief. Extensive studies have demonstrated birthing pool use during childbirth is safe for mothers and babies. It is associated with reduced medical interventions (e.g. speeding up labour and cuts to the perineum), improved outcomes (e.g. satisfaction, less pain or excessive bleeding after birth). Given these positive outcomes, we wanted to explore any barriers or facilitators for birthing women and people accessing birthing pools so we could help improve access for those wishing to use one. We gathered and assessed the literature to explore these aspects. We included quantitative and qualitative studies exploring the perspectives of different maternity professionals and those of organisations. We reviewed 37 studies from 12 countries (from 2004 to 2020). We found that birthing pool use was a viable option when all maternity professional groups and their organisational guidelines or policies valued and supported its use. Conversely, in other organisations, multiple barriers prevented the use of birthing pools as an equally viable option to medication pain relief options. These barriers were influenced by the beliefs of different maternity professional groups, organisational guidelines or policies (where some were highly restrictive) whether midwives were supported to offer care in birthing pools or whether the midwives had the confidence to do so. [ABSTRACT FROM AUTHOR]

Aims: To identify and synthesize the evidence regarding the facilitators and barriers relating to birthing pool use from organizational and multi-professional perspectives. Design: A systematic integrated mixed methods review was conducted. Data sources: MEDLINE, CINAHL, PsychINFO, EMCARE, PROQUEST and Web of Science databases were searched in April 2021, March 2022 and April 2024. We cross-referenced with Google Scholar and undertook reference list searches. Review methods: Data were extracted from studies meeting the inclusion criteria. Barriers and facilitators to birthing pool use were mapped and integrated into descriptive statements further synthesized to develop overarching themes. Results: Thirty seven articles (29 studies) were included—quantitative (12), qualitative (8), mixed methods (7), and audits (2), from 12 countries. These included the views of 9,082 multi-professionals (midwives, nurses, obstetricians, neonatologists, students, physicians, maternity support workers, doulas and childbirth educators). Additionally, 285 institutional policies or guidelines were included over 9 papers and 1 economic evaluation. Five themes were generated: The paradox of prescriptiveness, The experienced but elusive practitioner, Advocacy and tensions, Trust or Trepidation and It's your choice, but only if it is a choice. These revealed when personal, contextual, and infrastructural factors were aligned and directed towards the support of birth pool use, birthing pool use was a genuine option. Conversely, the more barriers that women and midwives experienced, the less likely it was a viable option, reducing choice and access to safe analgesia. Conclusion: The findings demonstrated a paradoxical reality of water immersion with each of the five themes detailing how the "swing" within these factors directly affected whether birthing pool use was facilitated or inhibited. Plain English Summary: During childbirth, most women wish to use a pain management technique; some prefer to use medications and others prefer non-medication methods. Another option is to use a birthing pool, larger than a typical bath, that encourages buoyancy and the freedom to move. The warm water can also offer comfort, relaxation and pain relief. Extensive studies have demonstrated birthing pool use during childbirth is safe for mothers and babies. It is associated with reduced medical interventions (e.g. speeding up labour and cuts to the perineum), improved outcomes (e.g. satisfaction, less pain or excessive bleeding after birth). Given these positive outcomes, we wanted to explore any barriers or facilitators for birthing women and people accessing birthing pools so we could help improve access for those wishing to use one. We gathered and assessed the literature to explore these aspects. We included quantitative and qualitative studies exploring the perspectives of different maternity professionals and those of organisations. We reviewed 37 studies from 12 countries (from 2004 to 2020). We found that birthing pool use was a viable option when all maternity professional groups and their organisational guidelines or policies valued and supported its use. Conversely, in other organisations, multiple barriers prevented the use of birthing pools as an equally viable option to medication pain relief options. These barriers were influenced by the beliefs of different maternity professional groups, organisational guidelines or policies (where some were highly restrictive) whether midwives were supported to offer care in birthing pools or whether the midwives had the confidence to do so. [ABSTRACT FROM AUTHOR]

Treating patients with up-to-date medical knowledge is an ongoing goal for healthcare workers and implies efficient knowledge management at the point of care. Widely available mobile wireless technologies influence practices but a significant gap remains between technological possibilities and actual usage. The purpose of this study was to analyze residents' baseline practices in managing medical knowledge and to evaluate the use and impact of an innovative multiplatform application dedicated to anesthesiology and intensive care residents. This study took place in Rennes Teaching Hospital and comprised two distinct surveys. First, in April 2018, all residents received a ten-items online survey focusing on managing medical knowledge. Then, through a second online survey constituted of ten items, we sought to assess the use of a new multiplatform cloud-based application named "DansMaBlouse", dedicated to sharing and indexing medical knowledge, in anesthesiology and intensive care residents. Among 148 residents that answered the evaluation survey, the most sought out pieces of information in clinical setting were a phone or fax number (74%), drugs' characteristics (68%) and expert guidelines (57%). The main sources were senior staff (68%), medical databases (60%) and an Internet search engine (59%). Computers and smartphones were more frequently used than bound paper notebooks. After implementation of the multiplatform application DansMaBlouse, fifty-nine (82%) of the 72 residents that answered the evaluation survey reported using the application and 39% used it more than ten times. Among application users, 90% found it easy to use and 92% agreed that it improved point-of-care access to knowledge. Accessing appropriate medical knowledge at the point of care remains an issue for residents and can be improved by a multiplatform application combining personal and shared up-to-date resources. [ABSTRACT FROM AUTHOR]

The last year saw intensive efforts to advance knowledge in pediatric medicine. This review highlights important publications that have been issued in the Italian Journal of Pediatrics in 2022. We have chosen papers in the fields of allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology. Novel valuable developments in epidemiology, pathophysiology, prevention, diagnosis and treatment that can rapidly change the approach to diseases in childhood have been included and discussed. [ABSTRACT FROM AUTHOR]

The author discusses cognition management in anesthesiology. Topics discussed include the use of cognitive behavioral therapy in managing chronic pain, the understanding of the postoperative cognitive dysfunction (POCD), and the etiology and risk factors associated with POCD. Information on the social impact and prevention of POCD is presented.

The article announces the Anaesthesia and Intensive Care Jeanette Thirlwell Best Paper Award for 2018 has awarded including Thomas Painter and colleagues from the Royal Adelaide Hospital and Adelaide Medical School.

Frequency, association and impact measures are key concepts in clinical epidemiology; however, it has been found that a considerable proportion of health students and professionals have no knowledge of how to use or interpret them when reading a scientific paper or conducting research. This article aims to explain the main epidemiological measures, how they are used, derived and interpreted. They are approached from the perspective of each of the most frequently used types of primary quantitative research studies (randomized clinical trials, cohort studies, case-control estudies and cross-sectional studies) in order to provide the reader with the context in which they are used. Moreover, the process for calculating and interpreting each result in a real setting is explained using clinical examples for a better understanding of these concepts and in order to prevent their use from becoming just a mechanical or repetitive exercise. [ABSTRACT FROM AUTHOR]

The article discusses the common statistical errors seen in published scientific studies or review papers. It highlights the two of the myriad problems identified in science reporting such as the misuse of statistics and the overinterpretation of data. The most often used statistical tests seen in the medical literature are also explored including the t-test and Chi-square test.

The effects of hypertension on perioperative outcomes are still unclear. No specific systolic or diastolic blood pressure measurement has been determined as the cutoff value to continue with a surgical plan or adjourn. This study is designed as a narrative review of the available scientific evidence on the perioperative management of hypertension. A search was conducted in Pubmed considering the title and abstract; 120 articles were pre-selected of which 55 papers were selected for full-text eligibility and 16 were excluded for a total of 39 articles including ACCF/AHA 2009 and ACC/AHA 2014 on perioperative cardiovascular care; 2013 ESH/ESC, 8 JNC, and the 2017 ACC/AHA/AAPA/ABC Guideline for the Prevention, detection, and management of hypertension in adults. Blood pressure values, target organ damage, and type of surgery should be considered for decision-making in the perioperative period. If surgery is elective, blood pressure fluctuations should be avoided and potential causes should be treated. A patient with mild hypertension with values below SBP 160 and DBP 110 mmHg may be managed in the ambulatory setting during the postoperative period, as long as the clinical conditions are favorable. [ABSTRACT FROM AUTHOR]

As the number of COVID-19 cases is rapidly increasing internationally, management, recommendations and guidelines of COVID-19 are rapidly evolving and changing. Formulating local clinical management policies among institutions adopting these recommendations is vital to staff as well as the patients' safety. Also, training multidisciplinary teams on these policies is an important, yet challenging, part of the process. The purpose of this paper is to present the process that has been followed to formulate COVID-19-specific response anesthesiology and operating room (OR) policies at King Abdulaziz University Hospital, by applying David A. Kolb's experiential learning theory during simulation-based training. This project had a total of six simulation-based sessions (four simulation scenarios and two clinical drills) designed to test the efficacy and efficiency of the then current practice in the hospital, facing the COVID-19 pandemic. Qualitative data analysis was completed using qualitative thematic data analysis. To apply experiential Kolb's theory, session's checklist (two raters per session), outcomes, and participants' feedback to develop and improve clinical management pathway in the department were used. The 12 reports and participants' feedback highlighted three main areas for improvement. These are Personal Protective Equipment implementation, team dynamics, and airway management. This process then guided in creating a new understanding of the multidisciplinary clinical management pathway, in addition to enhancing viability of the current practice and clinical management guidelines and protocols, which were already established and adapted at the hospital before the COVID-19 pandemic crisis. The alignment with Kolb's experiential theory helped formulate anesthesiology and OR effective clinical management pathway has been demonstrated. Applying experiential learning theory by a clinical institute using interprofessional, multidisciplinary simulations and clinical drills can guide the process of formulating clinical management pathways during pandemic outbreaks. [ABSTRACT FROM AUTHOR]

Ketamine is one of the earliest hypnotic substances known with anesthetic and analgesic qualities and little suppressive effect on breathing. Clinical ketamine use started in the 1970s. Its safety and capacity to elicit analgesia and anaesthesia for a brief period were advantageous to doctors. Ketamine has been used extensively in therapeutic settings. To provide insight into the many uses and to highlight the dosage, delivery mechanism, and time course of these effects, this review integrates several basic scientific, preclinical, and clinical studies on ketamine. Ketamine's most well-known dissociative anaesthetic effects are not its only effects, it also possesses analgesic, anti-inflammatory, and antidepressant properties. The drug's clinical utility was questioned by its psychodysleptic side effects. Ketamine is still used in veterinary medicine, field medicine, and specialised anaesthesia despite these undesirable side effects. A thorough literature search was conducted using Medline, Google Scholar, and PubMed. The relevant papers' complete texts were printed and read. There is also more information about the more recent applications of ketamine and its drawbacks. Since ketamine has a lengthy history of therapeutic usage in a variety of contexts around the world due to its complicated mechanisms of action, we have examined its complex pharmacological characteristics in this review and its many uses since it was first developed. Like any review, this one is constrained by publication bias and a lack of data on unfavourable research that was not published. [ABSTRACT FROM AUTHOR]

Background: One of the recently documented modalities of fascial plane block is the erector spinae plane (ESP) block, which was first described for the treatment of chronic thoracic neuropathic pain and postoperative pain in thoracic surgery. Since then, the technique has been used for a wide variety of clinical scenarios, including cardiac surgery. Aim: Through a review of clinical trials, to synthesize and evaluate the use of ESP block in cardiac surgery. Method: This is an exploratory study, based on the method of literature review with evidence synthesis. The database chosen for the selection of papers was PUBMED, using the following search strategy: "erector spinae plane block" AND "cardiac surgery". Studies published in the last five years were evaluated, and any paper that discussed the proposed topic and was a clinical trial was initially included in the sample. Results: Eleven studies were identified that met the previously established search strategy. After reading the titles and abstracts, one text was excluded because it was a letter to the editor. Conclusion: For all papers evaluated, ESP block provided good analgesia and safety during and after cardiac surgical procedures, being superior to classic techniques such as thoracic epidural anesthesia (TEA) and intravenous analgesia with or without opiates. This data was also confirmed in pediatric surgeries. In addition, ESP block was responsible for the reduction of several adverse effects typical of the classical methods of analgesia mentioned, such as nausea, vomiting and longer periods of mechanical ventilation. Another interesting finding was the association of the technique with analgesia of the superficial parasternal intercostal plane and pectoral nerve block, which provided a reduction in the use of opiates, an increase in the satisfaction of patients undergoing ESP block and a decrease in pain scores. [ABSTRACT FROM AUTHOR]

Traditionally, anesthetic records were in paper format. An increasing volume of complex data, legislation, and quality improvement initiatives related to clinical documentation have promoted the transition to digital records. Anesthesia information management systems (AIMS) have been designed to directly extract patient information from the anesthesia workstation and transmit the data into documentation systems and databases. The purpose of this review was to explore existing literature on anesthesia personnel's experiences with digital AIMS. Literature searches were conducted in PubMed, Cumulative Index to Nursing & Allied Health Literature, Embase, and The Cochrane Database of Systematic Reviews. A total of 473 records were identified, of which 40 records were read in full-text. Seven records underwent quality appraisal, representing research from 1991 to 2018, all with a quantitative design. In total, 379 anesthesia personnel were included. Five studies were conducted in the United States; 1, in Korea; and 1, in Germany. Results were collated into the themes user satisfaction, technical aspects, physical placement of the system, paper-based vs electronic data entry, quality of care, and suggestions for improvement. Findings indicate both positive and negative effects of AIMS. Anesthesia personnel's experiences should be included in the planning, development, and implementation of digital data entry systems. [ABSTRACT FROM AUTHOR]

Introduction: Tracking measures of quality over time has been shown to improve care within institutions and across health systems. Perioperative quality assurance (QA) tracking by anesthesia departments in the Military Health System (MHS) has not used a uniform system integrated into the workflow of anesthesia providers. The purpose of this study was to demonstrate that the use of the embedded QA outcome reporting feature in the anesthesia information management system (AIMS) increased the rate of reporting compared to the current paper reporting system in a military anesthesia department.Materials and Methods: An electronic outcome reporting mechanism embedded in the AIMS was activated as an alternative to paper QA outcome reporting. The proportion of anesthesia cases per month in a 12-month period with a reported QA outcome was compared to the previous year in which only the paper reporting system was used. The total number of cases in each time period with an outcome reported was compared using chi square for proportions, and systems were evaluated using the Statistical Process Control methodology. This project was evaluated and determined to be exempt from review by our institutional review board.Results: There was a 389.8% increase in the number of cases with a QA outcome reported after the implementation of the outcome reporting function integrated into the AIMS (χ2 = 207.72; P <.001, Table I). Systems before and after the intervention were stable, and special cause variation was noted only at the point of implementation of the electronic reporting system. Anesthesia providers were surveyed and felt that the addition of QA reporting to the AIMS made QA reporting more likely.Conclusions: The use of an electronic QA outcome reporting method integrated into the AIMS dramatically increased the likelihood that a QA outcome would be reported. The decreased administrative burden of the integrated outcome reporting system was likely the primary reason for this increase. This study was limited by the fact that it was done in a single institution; however, the size and timing of the increase clearly indicate that the intervention was the reason for improved reporting. Electronic health record upgrades should consider incorporating QA reporting into the AIMS across the MHS. These measures could allow for system-wide improvement, evaluation, and evidence-based education on their own, but also by facilitating participation in the American Society of Anesthesiologists' Anesthesia Quality Institute's National Anesthesia Clinical Outcomes Registry. This report serves as a valuable example to institutions and perioperative leaders in the MHS of how to improve the robustness of perioperative QA reporting such that it could be used to validate and improve the value of care. [ABSTRACT FROM AUTHOR]

John Davies Thomas (1844-1893) described a two-ounce drop-bottle for chloroform in 1872 while he was a resident medical officer at University College Hospital, London. After working as a ship's surgeon, he settled in Australia. In May 1875, Thomas presented a paper on the mortality from ether and chloroform at a meeting of the Medical Society of Victoria in Melbourne, Victoria. Surveys conducted in Europe and North America had established that the mortality from chloroform was eight to ten times higher than that from ether. At that time, chloroform was the most widely administered anaesthetic in Australia. Thomas' paper was published in The Australian Medical Journal and reprinted by the Medical Society of Victoria for distribution to hospitals in the Colony of Victoria. Later that year, Thomas moved to Adelaide, South Australia, where he may have been influential at the Adelaide Hospital in ensuring that ether was administered more often than chloroform. It does not appear that Thomas' papers on anaesthesia had a significant effect on the conduct of anaesthesia in Victoria or New South Wales. [ABSTRACT FROM AUTHOR]

Ehlers-Danlos syndrome (EDS) is a hereditary tissue and collagen synthesis disorder that can predispose patients to gynecologic and obstetric complications. Female patients often suffer from bothersome pelvic floor disorders, but due to the medical complexity of EDS, special considerations are needed for the treatment of pelvic organ prolapse and associated incontinence. In this paper, we present three unique cases of pelvic organ prolapse (POP) in EDS patients and delve deeper into the multidisciplinary approach involving urogynecology, rheumatology, physiatry, gastroenterology, and anesthesiology required to appropriately manage this condition. [ABSTRACT FROM AUTHOR]

Background: Hypothermia in surgical procedures (HPC) is defined as a drop in core body temperature to lower than 36°C, usually in the perioperative and postoperative periods. Even mild hypothermia could increase the incidence of surgical wound infections, postoperative myocardial ischemic events, blood loss during surgery, and prolonged postoperative recovery. Thus, providing and maintaining normothermia in the perioperative and postoperative periods is important for achieving optimal surgical results, as well as for the patient's safety and satisfaction. Proposition: To synthesize clinical evidence related to the prevention of HPC. Discussion: This is an integrative review of specialized medical literature, of an exploratory nature, which used the PUBMED database to select the reviewed papers, using the following strategy: hypothermia[title] AND prevention[title] AND (operative OR surgery OR surgical). Sixteen clinical trials published in the last 10 years were included in the review. The evidence presented demonstrated the effectiveness of several approaches to preventing HPC, such as the use of forced-air warming blankets (FAW), thermal blankets and combination heating systems. Conclusion: Despite the variations in core body temperature results and incidence of hypothermia between different methods and settings, in general, they all demonstrated some level of success in preventing HPC. [ABSTRACT FROM AUTHOR]

Depression is a significant factor contributing to postoperative occurrences, and patients diagnosed with depression have a higher risk for postoperative complications. Studies on cardiovascular surgery extensively addresses this concern. Several studies report that people who undergo coronary artery bypass graft surgery have a 20% chance of developing postoperative depression. A retrospective analysis of medical records spanning 21 years, involving 817 patients, revealed that approximately 40% of individuals undergoing coronary artery bypass grafting (CABG) were at risk of perioperative depression. Patients endure prolonged suffering from illness because each attempt with standard antidepressants requires several weeks to be effective. In addition, multi-drug combination adjuvants or combination medication therapy may alleviate symptoms for some individuals, but they also increase the risk of side effects. Conventional antidepressants primarily modulate the monoamine system, whereas different therapies target the serotonin, norepinephrine, and dopamine systems. Esketamine is a fast-acting antidepressant with high efficacy. Esketamine is the S-enantiomer of ketamine, a derivative of phencyclidine developed in 1956. Esketamine exerts its effect by targeting the glutaminergic system the glutaminergic system. In this paper, we discuss the current depression treatment strategies with a focus on the pharmacology and mechanism of action of esketamine. In addition, studies reporting use of esketamine to treat perioperative depressive symptoms are reviwed, and the potential future applications of the drug are presented. • This review illustrates current concerns about cognitive impairment. • The review discusses the unpredictable potential value of the new drug esketamine. • The review cites a large number of studies, the most recent studies, and the most classical studies to prove the point. • The description of esketamine is comprehensive and detailed. • It has certain reference significance for the treatment of perioperative depression. [ABSTRACT FROM AUTHOR]

Introduction: Negative pressure pulmonary edema (NPPE) is an uncommon perioperative complication with a potentially fatal outcome. It is most predominant in young healthy men undergoing surgical procedures under general anesthesia. Due to its rare occurrence and uncharacteristic clinical presentation, it poses a potential diagnostic pitfall. Aim: The purpose of this article is to present clinical characteristics and management of NPPE. Material and methods: This paper is based on the available literature and the authors’ experience. Results and discussion: Clinical presentation of NPPE is uncharacteristic and includes i.e. agitation, tachypnea, tachycardia, cyanosis and pink frothy sputum. Postponed extubation after general anesthesia is believed to be optimal in order to prevent NPPE as it minimizes asynchrony of muscle function reversal and probability of laryngospasm. Differential diagnosis includes and is not limited to pulmonary edema, aspiration pneumonia, anaphylaxis, septic shock, pulmonary embolism or exacerbation of bronchial asthma. Management of NPPE is symptomatic and focuses on symptomatic treatment and maintaining an open airway passage. Endotracheal intubation with low tidal volume ventilation of 6 mL/kg of ideal body weight with a plateau pressure of less than 30 cm H2O and high positive end-expiratory pressure (PEEP) may improve patients outcomes. Conclusions: It is crucial for anesthesiologists to familiarize themselves with this phenomenon for early recognition and proper therapeutic decisions. It should be emphasized that under the highest risk of developing NPPE are young male patients and the most common cause is post-extubation laryngospasm. [ABSTRACT FROM AUTHOR]

Measurement of quality and improvement in medicine has existed since Florence Nightingale's time. In modern times, medicine has sought to learn from other high‐reliability industries such as aviation and nuclear power, where errors can result in catastrophic outcomes. Lean is a unique quality improvement strategy that seeks to improve both quality and safety by driving out waste and, where possible, standardizing work practices. It is a visual system with work aids and signals built into the workspace. An important tenet is that ideas come from the workers and that there is an iterative improvement. The improvement efforts are always viewed from the perspective of the customer, our patients, families, and coworkers. This paper describes the evolution of Lean in healthcare and highlights core principles of Lean. Examples are used to describe how various Lean tools can be applied by pediatric anesthesiologists to solve clinical problems. [ABSTRACT FROM AUTHOR]

Anesthetic gases are potent greenhouse gases, which are currently released into the atmosphere where they remain for many years. Strategies to reduce the carbon footprint in anesthesiology without compromising patient safety are urgently needed. Since 2020 several departments of anesthesiology have installed anesthetic gas capture systems with which anesthetic gases can be collected. This article aims to describe the anesthetic gas capture system CONTRAfluran™ and to give an overview of the first experiences in four departments of anesthesiology working with the new device in the daily clinical routine. The CONTRAfluran™ system presents a new concept in the surgical setting that has the potential to reduce the carbon footprint in anesthesiology; however, in order to accurately estimate CO2 equivalent savings, more information concerning the reprocessing and data on the pharmacokinetics of anesthetic gases are needed. Application of the CONTRAfluran™ system in daily clinical routine is feasible when anesthesiologists are aware of specific issues. In order to minimize the carbon footprint, it remains essential to implement the specific recommendations in the position paper of the German Society of Anaesthesiology and Intensive Care medicine (DGAI) and the Professional Association of German Anaesthesiologists (BDA) on ecological sustainability in anesthesiology and intensive care medicine and to support further research. [ABSTRACT FROM AUTHOR]

Context: Fraudulent publication is a scourge of scientific research. Objectives: This scoping review was aimed at characterizing retracted publications for fraud or plagiarism in the field of anesthesia. Does the reputation of the journal (Quartile and Impact Factor, IF) protect the reader from the risk of having the manuscript he read withdrawn for fraud/plagiarism? Methods/Design: This scoping review was planned following the Joanna Briggs Institute recommendations. Data sources: PubMed and the Retraction Watch Database (http://retractiondatabase.org/RetractionSearch.aspx?). Study selection: All types of publications retracted. Data extraction: Year, first author nationality, journal name, journal category, IF, Quartile, H index. Data analysis: The association with Quartile and IF was investigated. Results: No significant association between retraction of papers published in no‑Quartile journals and retractions published in journals placed in the highest quartile. Conclusions: The quality of the surveillance in paper submission is not higher in journals of the first Quartile than in journals not placed in other Quartiles. (The protocol was prospectively registered in the Open Science Framework https:// doi.org/10.17605/OSF.IO/TGKNE) [ABSTRACT FROM AUTHOR]

Background: Almost a quarter of the anesthetic procedures currently performed in children involve regional anesthesia. In turn, caudal block (CB) is one of the most widely used techniques in pediatric patients undergoing subumbilical interventions. Aim: Through an integrative literature review, to synthesize and evaluate the use of BC in pediatric inguinal surgeries. Method: This is an exploratory study, based on the method of literature review with evidence synthesis. The database chosen for the selection of works was PUBMED, using the following search strategy: (caudal[title] AND block[title]) AND inguinal[title] AND (pediatric OR pediatric). Results: The search was carried out in November 2022, and initially 13 studies were identified that met the aforementioned search strategy. After reading the titles and abstracts, no paper was excluded. Conclusion: In general, CB with bupivacaine proved to be a safe and applicable technique in pediatric inguinal surgeries, promoting good analgesia and showing few adverse effects. In addition, the use of CB with bupivacaine in association with tramadol demonstrated safety, in addition to promoting prolonged analgesia. Furthermore, the use of BC in association with dexamethasone, 2-chloroprocaine and levobupivacaine as main anesthetics were positively evaluated. However, when compared to paravertebral block, analgesic infiltration directly into the wound, quadratus lumborum block and transversus abdominis plane block, CB was considered inferior in terms of analgesia duration and pain scores. Finally, BC was superior in terms of analgesia when compared to the use of paracetamol suppository, in addition to analgesia comparable to ultrasound-guided ilioinguinal analgesia. [ABSTRACT FROM AUTHOR]

While 2020 was significantly affected by the SARS-CoV-2 pandemic, including publications, 2021 has already returned to "normal". Almost back to normal, because the world, medicine, and even anaesthesia, will never be what they used to be. What COVID-19 has changed is that the safety of what we do has come much more to the fore. The safety of our procedures and the safety of each anaesthetic, but not only. The aim of this text is to briefly summarise some key publications in the field of anaesthesiology, and to highlight papers that should not escape attention. [ABSTRACT FROM AUTHOR]

Introduction: the blended SORT-IT model uses a combination of online modules and teleconferences with local and international mentors to teach operational research. We modified SORT-IT to create the Acute Care Operational Research (ACOR) course directed to anesthesiology residents in Kigali, Rwanda. This course takes students from an initial research idea through submitting a paper for publication. Our viewpoint on entering this study was that ACOR participants would have adequate resources to complete the course, but be hampered by cultural unfamiliarity with the blended teaching approach. Methods: we conducted a qualitative analysis of the experiences of all those who participated in the ACOR course to understand obstacles and improve future course iterations. Six anesthesiology residents participated in the first iteration of the course, with 4 local mentors and 2 secondary mentors, one of whom was based at the University of Virginia, with a total of 12 participants. Semi-structured interviews were conducted with all participants and mentors, which were independently coded for topics by two reviewers. Results: there was a 50% publication rate for those enrolled in the course and an expected 100% acceptance rate for those who completed the course. Some reported benefits to the course included improved research knowledge, societal improvements, and knowledge exchange. Some reported obstacles to successful course completion included time limitations, background knowledge, and communication. Of note, only 4 out of 12 participants recognized cultural barriers. Conclusion: although successful in the sense that all participants completed their research project, ACOR did not fully solve the main issues hindering research training. Our results show that research training in low-resource settings needs a continuing and formal focus on the factors that hinder participants' success: mentorship and time. [ABSTRACT FROM AUTHOR]

Bibliometric analyses may indicate the most active journals, authors, countries, institutions and specialties by evaluating the most cited articles in a given research field. To the authors' knowledge, there is no bibliometric analysis regarding neurocritical care research. Thus, the aim of this study is to analyze and to provide a scope of the current scientific production in this area. The 100 most cited articles in the neurocritical care research were retrieved from the research "(neurocritical) AND (care)" in the Scopus database. The variables collected and included in this analysis were: number of citations, article title, first author's name, year and journal of publication and its impact factor (IF), specialty, affiliation and country of the corresponding author at the time of publication, and category of the article. Also, these variables were assessed for primary research only. The articles were published in 34 different journals from 1995 to 2017, with a mean citation number of 109.36, ranging from 44 to 540. Neurocritical Care (23 articles in top 100 and 2190 citations, IF = 3.163) and Critical Care Medicine (20 articles and 2896 citations in top 100, IF = 6.630) were the journals with the greatest number of articles and citations, respectively. Neurocritical Care also had the highest number of primary research papers (15 articles, accounting for 850 citations). Excepting one article from Asia (Singapore) and one from Oceania (Australia), all the other 98 papers were from North America (67) or Europe (31). United States was the country with most articles (60, 35 primary research) and citations (6115) among the top 100. Columbia University (11 articles, being 7 primary research, and 915 citations) was the institution with the highest number of articles and primary research articles in top 100, whereas University of Heidelberg (6 articles and 1220 citations) was the most cited institution. Neurology was the specialty with the greatest number of publications in top 100 and the most cited one (57 articles and 5983 citations). The first author with the greatest number of publications as well as primary research articles was A. I. Qureshi (5 articles, being 4 primary research, and 660 citations), while the most cited was K. H. Polderman (2 articles and 749 citations). Fifty-nine publications were primary and 41 secondary research. Among primary research, treatment/management was the most frequent and most cited topics (33 articles and 4172 citations). To the authors' knowledge, this is the first bibliometric analysis regarding neurocritical care research. Our findings suggest that the neurocritical care research field is more prominent in North America and Europe, more frequently published in specific critical care journals and after 1994. The most discussed topic was related to treatment and/or management within neurocritical care. [ABSTRACT FROM AUTHOR]

This bibliography records the 88 papers published by Australian and New Zealand authors in the Proceedings of the first nine International Symposia on the History of Anaesthesia (ISHA). Each ISHA has produced a published Proceedings of each symposium and these form an extremely valuable medical history research resource of over 850 papers. These have been published by a variety of anaesthesia societies, medical publishers and other bodies from around the world. Nearly all of these Proceedings had one small print run and most are now out of print and often unavailable. There is a definite need for all ISHA Proceedings to date to be available at one online site for ease of access for future historians studying the history of anaesthesia, intensive care, pain medicine, resuscitation and related fields. Scanning of early Proceedings with appropriate publisher, author and editorial approval would facilitate this. [ABSTRACT FROM AUTHOR]

Summary: Background: Medication errors pose a significant risk perioperatively. In the perioperative environment, common medication administration processes are not typically performed. Given the common administration of potentially harmful medications and the potential for medication errors, patient risk is substantial. Specifically, intravenous acetaminophen has been used more frequently in the perioperative period which yielded an increase in medication administration errors reported. Aims: This project was initiated by Cincinnati Children's Hospital after an increase in perioperative acetaminophen dosing errors was reported. After mapping the administration process of perioperative acetaminophen, we sought to reduce medication errors by the use of a safety checklist. Acetaminophen was used as a surrogate for other perioperative medications in this quality improvement project. Methods: Use of a failure mode effects analysis assisted the team in understanding the failures of the process of safe medication administration. Subsequently, key drivers of this process were designed to include accurate understanding and documentation of medication history, consistent communication between perioperative caregivers, and an efficient checklist process. A multidisciplinary team conducted a series of tests to modify key drivers. Data were collected by utilizing data from a paper checklist, prior to the electronic medical record change that was prompted by this study. A total of 633 checklists and electronic medical records were analyzed during a 6‐month period; data were analyzed using control charts and statistical process control methods. Results/Analysis: The percentage of compliance with the safe administration checklist for acetaminophen in the preoperative period increased to 97%. Use of the paper checklist likely prompted the appropriate increase in compliance with safe administration. Additionally, provider‐specific feedback produced a significant increase in compliance with the use of the checklist. Conclusion: Application of quality improvement methods, specifically a safety checklist, were utilized to improve the safe administration of acetaminophen during the perioperative period. Increasing reliability of accurate delivery and administration of medication to patients are crucial in optimizing patient safety. Use of a medication safety checklist may be beneficial in reducing potential administration errors, specifically for high‐risk medications. [ABSTRACT FROM AUTHOR]

Physician burnout and healthcare worker stress are well‐covered topics in both the medical and lay press. Burnout in physicians can start as early as medical school. Well‐being initiatives, programming, and access to support for all medical professionals are of paramount importance. In 2014, the Accreditation Council for Graduate Medical Education (ACGME) Milestones for Resident/Fellow Education in Anesthesiology added Professionalism as a milestone. A subcategory of Professionalism includes: A responsibility to maintain personal, emotional, physical, and mental health. This subcategory charges all residency and fellowship programs with establishing a curriculum in well‐being. The development, execution, and evaluation of these programs are left to the individual institutions. In this paper, the development, processes, and preliminary outcomes of a resident well‐being curriculum are presented. [ABSTRACT FROM AUTHOR]

Introduction: Modern health care implies the continuous development of human resources and the application of pharmacoeconomic analyzes during the introduction of new methods of treatment in medicine. Aim: The aim of the paper is to compare and analyze: 1) the number of: operated patients, provided anesthesia services, hospital days in ICU and surgery interventions; 2) distribution of anesthetic services: general anesthesia, local anesthesia and anesthesia procedures and 3) the values of direct costs of anesthesiology and reanimatology , in 2006 and 2015 in order to propose measures of rationalization and savings of funds. Methods: This paper is part of an academic IV phase study , conducted at the Clinical Center of Serbia (CCS) with the permission of the Ethical Committee of the Medical Faculty of the University of Belgrade (470 / IV7) and harmonized with the European Union Directive. Direct costs of anesthesiological services of the Center for Anesthesiology and Reanimatology, by department of anesthesia in the maternal surgical clinics of the Clinical Center of Serbia in Belgrade, during 2006 and 2015, are included and analyzed. The subjects were all anesthetized patients, both sexes, children and adults.The numeric data is processed by Microsoft Office Excel 2003 and SPSS for Windows. For the analysis of the statistical significance of the number of patients, anesthesiologic services, hospital days in Intensive Care Units and surgical procedures was used Wilcox test.In order to analyze the percentage distribution of funds in the category of direct costs (personal costs, drugs, materials, analyzes and medical equipment), in 2015 compared to 2006 was used the hi-square matching test. Results: There is a statistically significant difference in the frequency of service categories within the scope of services in 2015 compared to 2006 (p <0.001), indicators of hospital work. There is a statistically significant difference in the frequency of anesthetic services in 2015 compared to 2006 (p <0.001). There is a statistically significant difference in the total direct cost of anesthesiology and reanimatology between 2006 and 2015 (p = 0.043). There is a statistically significant difference in the frequency of direct cost categories in 2015 relative to 2006 (p <0.001). In the period of recession and transition in 2006, 42% of funds for personal expenses were separated, for medicines and materials 29%, analyzes and medical devices 29%. The direct costs of anesthetic services would be at the annual level of 10% relative to the means of surgical activity.Without taking into account methodological concerns (organizational changes, introduction of new groups of drugs in the responsibility of anesthesiologists, limiting legal regulations, higher prices), after a ten-year period, the ratio of direct costs was changed in 2015, so that personal costs amount to 4%, drugs and materials amount to 94% and analysis and medical equipment amount to 2%. Conclusion: 1. The 10-fold decrease in personnel costs in 2015 statistics is certainly not a consequence of a change in the methodology, but a constant, chronic and progressive impairment of vocational work in total health care costs. 2. Anesthetist services are only visible during their stay in the operating room. It is evident that most of the services performed in: preoperative assessment and preparation, immediate postoperative and delayed, chronic treatment of critical patients, are either unrecognized or incorrectly attributed to surgical specialties. 3. The quality of the statistical data presented is indicating the lack of interest of the hospital administration in analyzing and utilizing the collected data in reducing and rationalizing health care costs. 4. Academic multicenter studies in pharmacoeconomics are needed to help doctors to achieve a better uniform standards of providing anesthesia services using evidence based medicine. [ABSTRACT FROM AUTHOR]

The original version of this article unfortunately contained a mistake. [ABSTRACT FROM AUTHOR]

Pilot and feasibility studies are preliminary investigations undertaken before a larger study. We hypothesised that only a small proportion of pilot or feasibility studies published in anaesthesia journals were correctly labelled as such. We searched for papers published between 2007 and 2017 in six anaesthesia journals using the text words 'pilot' OR 'feasibility' and included 266 original articles with 26,682 human participants. Only 34 (12.8%) were correctly labelled as a pilot or feasibility study. They were more likely to: have more median (IQR [range]) participants, 73 (40-130 [4-2716]) vs. 27 (15-60 [2-3305], p < 0.001; report feasibility outcomes, 82.4% vs. 4.3%, p < 0.001; and report an intention to convert, 100% vs. 39.7%, p < 0.001. They were less likely to test the efficacy of the primary outcome, 50% vs. 72.8%, p = 0.009; and report firm clinical conclusions 41.2% vs. 67.7%, p = 0.004. Of the studies published more than 5 years ago, correctly labelled pilot or feasibility studies were more likely to precede a published conversion study, 53.8% vs. 16%, p = 0.004. There was no difference between the number of citations 18 (9-44 [2-216]) vs. 20 (7-47 [0-251]), p = 0.865. These results have important consequences for patients, trialists, researchers and funders. We argue that correctly labelled pilot studies enhance the quality of scientific research by encouraging methodological rigour, ensuring scientific validity and reducing research waste. Authors, reviewers, editors and publishers should ensure they adhere to the contents of the 2016 CONSORT extension for pilot and feasibility studies. [ABSTRACT FROM AUTHOR]

Aim: The internet is one of the most frequently used tools to reach up to actual information. In the field of health, patients frequently search for treatment options and outcomes over the internet. In this study, the quality and reliability of the data on obstetric anesthesia were investigated. Material and Methods: The ten most frequently searched keywords for obstetric anesthesia and the first 30 search results for each word were analyzed with JAMA Benchmark Criteria and Discern score. The web sites that emerged as servers were divided into 5 classes as anesthesia associations and academic papers, public institutions, private hospitals/clinics, news and forums/personal blogs. Results: The average DISCERN score of all sites was calculated as 29.75±7.04. The quality of the information provided on the internet about obstetric anesthesia was evaluated as poor. The most common results for our keywords were provided by private hospitals (27.8%). Web sites linked to public institutions were the last to provide information (2.2%). Treatment options and benefits are the most clearly mentioned issues, while risks and treatment failure are the least addressed. According to the JAMA benchmark criterion, the majority of sites had up-to-date but unclear information. Conclusions: In obstetric anesthesia, the quality and reliability of the information provided on the internet are poor. It was concluded that the anesthesiology associations were not sufficiently involved on the internet in informing patients about obstetric anesthesia. Patients applying in health institutions should be advised that the information on the internet may not be reliable and that they should consult a specialist physician. [ABSTRACT FROM AUTHOR]

This study evaluated whether there were improvements in the number of departmental National Institutes of Health (NIH) training grants and the academic productivity of departmental chairs in terms of NIH research funding and PubMed-cited publications when compared to chairs of the same departments in 2006. Each chair was identified from the Society of Academic Associations of Academic Anesthesiology & Perioperative Medicine's Association of Academic Anesthesiology Chairs and entered into the NIH Research Portfolio Online Reporting Tools (RePORTER), PubMed, SCOPUS, and the National Provider Identifier Registry. The number and funding amounts of training grants awarded to the department in 2010, 2015, and 2020 were obtained as well as the department's national ranking and total dollar amount for NIH funding in 2020. For the current chair cohort, total publications and m-quotient (h-index corrected for active research years) were recorded along with each chair's history of NIH grant funding. These data were compared to a previous study of anesthesiology chairs that reviewed funding and publications through 2006. We analyzed data from 100 academic departments of anesthesiology and compared their scholarly activity relative to data gathered in 2006. In 2020, 52 of 100 departments of anesthesiology had evidence of NIH funding. There were not statistically significant (P > 0.05) differences in grants funding obtained by chairs between 2006 and 2020 with the exception that more chairs in 2006 had program or center grants. Median publications for chairs significantly increased from 35 in 2006 to 55 in 2021 (IRR = 1.5, 95% CI = 1.2–2.0, P = 0.003). Nineteen percent of chairs were female, which did not significantly differ from the proportion of women in the 2006 paper (15%, χ2 = 0.57, df = 1, P = 0.452). Of the male chairs, 90% were professors whereas 63% of female chairs were professors (χ2 = 8.8, df = 1, P = 0.003). Female chairs had fewer publications than male chairs (IRR = 1.8, 95% CI = 1.2–1.8, P = 0.002); however, m-quotients were not significantly different between men and women (P = 0.602). When compared to 2006, department of anesthesiology chairs had more publications in 2021; however, NIH funding rates remained unchanged. The specialty had 19% female chairs, and those chairs had fewer publications than their male counterparts, though sex differences were attenuated using metrics that account for disparities in career length. • Anesthesiology academic chairs had more PubMed-cited publications in 2021 than 2006. • Female department chairs had fewer publications than their male counterparts. • Chairs of NIH-ranked vs. unranked departments had more NIH funding and publications. • Percentage of female anesthesiology chairs remains unchanged over the last 15 years. • The proportion of departments with training grants has increased since 1995. [ABSTRACT FROM AUTHOR]

Background: Journal editors have exercised their control over submitted papers having a high similarity index. Despite widespread suspicion of possible plagiarism on a high similarity index, our study focused on the real effect of the similarity index on the value of a scientific paper. Methods: This research examined the percent values of the similarity index from 978 submitted (420 published) papers in the Korean Journal of Anesthesiology since 2012. Thus, this study aimed to identify the correlation between the similarity index and the value of a paper. The value of a paper was evaluated in two distinct phases (during a peer-review process vs. after publication), and the value of a published paper was evaluated in two aspects (academic citation vs. social media appearance). Results: Yearly mean values of the similarity index ranged from 16% to 19%. There were 254 papers cited at least once and 179 papers appearing at least once in social media. The similarity index affected the acceptance/rejection of a paper in various ways; although the influence was not linear and the cutoff measures were distinctive among the types of papers, both extremes were related to a high rate of rejection. After publication, the similarity index had no effect on academic citation or social media appearance according to the paper. Conclusions: The finding suggested that the similarity index no longer had an influence on academic citation or social media appearance according to the paper after publication, while the similarity index affected the acceptance/rejection of a submitted paper. Proofreading and intervention for finalizing the draft by the editors might play a role in achieving uniform quality of the publication. [ABSTRACT FROM AUTHOR]

Thousands of infants and children undergo complicated surgical procedures that require prolonged periods of anesthesia and/or sedation each year. A growing body of preclinical research suggests pediatric anesthetics are harmful to the developing brain; yet, the extent to which these effects generalize to the clinical setting remains unclear. As there will be a continuing need for surgical and other interventions requiring sedation and/or anesthesia during the neonatal period, it seems clear that research efforts should focus on determining the extent to which general anesthetics can affect the developing brain as well as determining strategies for preventing or ameliorating the adverse effects associated with exposure to such agents. The purpose of this paper is to provide a review of the preclinical literature examining the effects of general anesthesia on brain and behavioral development. This paper will detail the effects of different anesthetic agents on various indices of neurotoxicity and functional outcomes as well as provide a review of potential protective compounds and suggestions for areas of future research. [ABSTRACT FROM AUTHOR]

Introduction: 30 to 60% of patients admitted to non-psychiatric wards have at least one significant psychiatric illness. Objective: The aim of this study was to investigate the frequency, causes, and quality of psychiatric counseling requested. Materials and Methods: This descriptive study was carried out on all patients admitted to educational hospitals in Rasht, Iran from 2012 to 2014, for which psychiatric consultation was requested and their counseling sheets were available. Data were extracted based on the checklist. Assessment of the quality of the consultation request and the response quality of the counseling were done. Data were analyzed by SPSS21. Results: The frequency of psychiatric counseling application in this study was calculated to be 0/3%. A total of 905 counseling papers were reviewed. According to the data, 51/1% of patients were female and 48/9% were male, with the mean age of 45/7 years. For 54/7% of the patients, emergency counseling and for 45/3%, of them non-emergency counseling was requested. The most requesting counseling departments were surgery and internal medicine (14/6% and 12%, respectively). The lowest frequency of consultation requests was for anesthesiology department (0/1%). The most common reason for requesting psychiatric counseling was restlessness (26/75%) and then medication setting (14/45%). The most common diagnostic suspicion in response to counseling was delirium and the average duration for requesting counseling was 2.9 days after admission. Conclusion: Considering the relatively low frequency and quality of counseling in this study, more attention to the use of psychiatric counseling in medical patients and coherent training of assistants to improve the quality of counseling seem necessary. [ABSTRACT FROM AUTHOR]

Simulation-based education is often highlighted as a method to prepare health personnel to handle clinical emergencies through repeated training and the design of supports. As one of the most common clinical emergencies in anaesthesia, anaphylaxis is often included in simulation scenarios at both graduate and postgraduate levels. Case reviews of anaphylaxis management continue to identify deficiencies in clinical responses. We evaluated the evidence to support the use of simulation to address these deficiencies. We undertook a comprehensive review of the MEDLINE and Embase databases with MESH terms 'Anaphylaxis', 'Anaesthesia', 'Simulation training', and variations of these terms. Articles were also searched from reference lists in the identified papers. A total of 39 articles on perioperative anaphylaxis simulation were identified, with most focusing on the clinical skills of individuals. However, anaphylaxis scenarios are also being used in assessment of teams and in the evaluation of broader system performance. Many countries mandate simulation training and competency assessment at graduate and postgraduate levels: despite this, none of the articles linked simulation training or assessment with improved patient management or outcomes. We found evidence that in situ simulation and use of cognitive aids lead to improved teamwork and task performace. Quantitative and qualitative evidence for simulation-based perioperative training is limited. Future studies should investigate whether simulation training in perioperative anaphylaxis, particularly in situ simulation, translates into improved patient management and outcomes. [ABSTRACT FROM AUTHOR]

Background: Monitoring Caesarean Section (CS) rates is essential to ensure optimal use of the procedure. Information on CS rates in the South African private sector is limited and information from this study will assist in planning for the proposed NHI in South Africa. Objectives: The objectives of this paper are to assess mode of delivery patterns and to determine CS rates amongst South African private health insurance scheme members; and to assess the extent to which CS rates are influenced by age and health status of the mother. Methods: The 2015 claims for members of 10 health insurance schemes were analysed to assess delivery type patterns. Mode of delivery patterns were assessed by 6 delivery types: emergency, elective and “other” for caesarean deliveries; and non-assisted, assisted and “other” for vaginal deliveries; as well as by age and health condition of the mother. Results: Of a total of 6,542 births analysed, 4,815 were CS giving a CS rate of 73·6% (95% CI 72·5%;74·7%). Emergency CS were the most common mode of delivery (39·7%), followed by elective CS (39·5%). CS rates increased with increasing maternal age and were higher for women with a medical condition. Conclusions: CS rates for the South African private sector are considerably higher than the safe rates recommended by the WHO. The high CS rates is a cause for concern for the health system under the proposed NHI. To support initiatives encouraging evidence based practice, further research is required to understand the drivers for the high CS rates. [ABSTRACT FROM AUTHOR]

The paper is a continuation of the cycle of articles about the importance of structures the fascia planes for regional anesthesia. This article builds on the general part and deals with fascia planes and spaces in the neck area. The main neural vascular bundle passes between the surface and the deep fascia of the head towards the fuselage. Detailed knowledge of the fascial spaces makes it easy to understand the distribution of local anesthetics and minimizes the possible complications of unwanted Central blockades, vegetative and motor nerves. [ABSTRACT FROM AUTHOR]

We examined the prevalence of novel acronyms in the titles of anaesthetic and related studies and the response of anaesthetists to them. We separately analysed trainee-led research projects in the UK supported by the Research and Audit Federation of Trainees (RAFT), and a 10-year cohort of papers identified using the PubMed literature search tool. We also conducted a survey of 20 anaesthetists within our institution regarding the utility and impact of titles containing acronyms, and their recall of the associated topics. Finally, we developed a scoring system for acronym accuracy and complexity, the ORigin of AcroNym letterinG Used Term AppropriateNess (ORANGUTAN) score, and measured the progression of acronym usage over the 10-year period studied. Our results show that while acronyms themselves are sometimes considered memorable, they do not aid recall of topics and are, in general, not considered helpful. There has been an increase in the prevalence of acronymic titles over 10 years, and in the complexity of acronyms used, suggesting that there is currently a selective pressure favouring the use of acronyms even if they are of limited benefit. [ABSTRACT FROM AUTHOR]