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GLG News by Anesthesiologists (US)

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November 26, 2008
Why hasn't EHR been adopted faster
Analysis of: Survey: Hospital EHR Adoption Rate is Below 12% | www.govhealthit.com
Author: John Hsu, Director of Anesthesiology , Presbyterian Intercommunity Hospital Inc
The lack of a comprehensive EHR implementation suggests that we are failing at our goal of improving the healthcare system.  While the article highlights many problems, very few solutions are offered to remedy this part of our healthcare crises. The key implications are: 1....
November 21, 2008
Later Administration of Alvimopan (Entereg, Adolor) Accelerates GI Recovery
Analysis of: Study Published In Archives Of Surgery Demonstrated Benefit Of Entereg (Alvimopan) In Postoperative Ileus | pharmalive.com
Author: GLG Expert Contributor
Alvimopan given 30 to 90 minutes before surgery showed similar benefit as when given more than 2 hours pre-operatively.  Since patients often don’t arrive at the hospital 2 hours before surgery, it would certainly be more convenient to administer the drug closer to the time of surgery.
August 15, 2008
Byetta - what needs to be done
Analysis of: Lilly Diabetes Drug Shows a Life-Extending Promise | www.nytimes.com
Author: GLG Expert Contributor
Very interesting results; Need more information. Did Janumet also result in weight loss? does weight loss disappear after a while? Was weight loss associated with an improvement in cardiovascular hemodynamics, lipid profile and elasticity of blood vessels; it will be interesting to see if the secondary...
August 6, 2008
POISE: don't let it change your practice
Analysis of: Higher Risk of Death and Stroke in Patients Given Beta Blockers After Non-Cardiac Surgery (POISE Trial) | pharmalive.com
Author: GLG Expert Contributor
1. 10% of the data was rejected because the data was "fraudulent" - ie: research centers received payment, but there was not actually a patient associated with the data points. 2. No oversight was conducted of the research locations.  A majority of research centers were in various 3rd world countries. ...
July 2, 2008
Anesthetic factors that modulate postoperative pain
Analysis of: Why anaesthetics can make the pain worse | www.newscientist.com
Author: GLG Expert Contributor
1/ Genetic factors. Data indicate that genetic factors modulate the anesthetic requirement to control pain duirng and after surgery 2/ Gender sensitivity to anesthetics 3/ Anesthesia or lack of it  may lead to increase postoperative pain 4/ lack of proper perioperative monitoring of pain 5/ lack...
May 19, 2008
Improving anesthetic/surgical outcomes- the role of pharmacoprophylaxis
Analysis of: Higher Risk of Death and Stroke in Patients Given Beta Blockers After Non-Cardiac Surgery (POISE Trial) | pharmalive.com
Author: GLG Expert Contributor
To most in anesthesia, a "good anesthetic" is when the patient is delivered to the post anesthesia care unit in a stable fashion.  However, it may be more complicated and success is determined by 30-180 day markers of myocardial or CNS morbidity.  Unfortunately, this type of followup is not...
May 15, 2008
Production techniques cause unsafe heparin to be spread through the world resulting in mortality
Analysis of: U.S. Identifies Tainted Heparin in 11 Countries | www.nytimes.com
Author: GLG Expert Contributor
The issues are several: A wave of disease infected and killed many Chinese pigs (whose intestines are raw source material for heparin) and this drove up prices while decreasing supply. Heparin is a low cost, generic drug requiring an extremely tight supply chain to keep costs down.  ...
May 15, 2008
POISE shows high-dose beta blockers reduce heart attacks but cause more harm than good overall.
Analysis of: Higher Risk of Death and Stroke in Patients Given Beta Blockers After Non-Cardiac Surgery (POISE Trial) | pharmalive.com
Author: GLG Expert Contributor
This study again showed reduced cardiac events with peri-operative beta blockers.   However, patients had higher overall mortality from all causes relative to placebo.  Increased stroke rates provide some explanation. This study used a starting dose 8 times recommended.  Previous studies...
May 15, 2008
Sustained-release Hydrocodone - so what?
Analysis of: New Abbott Study of Investigational Vicodin CR(TM) Meets Primary Efficacy Endpoints in Phase III Trial | www.prnewswire.com
Author: GLG Expert Contributor
Abbott is developing a sustained-release formulation of hydrocodone.
May 14, 2008
Anti=inflammatory agents not protective for Adult dementia
Analysis of: Anti-inflammatory Drugs Do Not Improve Cognitive Function in Older Adults | pharmalive.com
Author: GLG Expert Contributor
1.  anti-inflammatory agents did not protect against adult onset dementia 2.  further testing with different anti inflammatory agents may be helpful

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