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Why I’m thankful for my daughter’s MRSA

“What time is surgery today?” Ellie, age 12, croaks. She hasn’t opened her eyes yet, but she knows she’s headed to the operating room … again. It may be the fourth surgery this month, maybe the fifth. We don’t know. What we do know is our routine has changed from soccer carpools and homework battles to twice-weekly trips to the operating room, where the orthopedic surgeon will slice open my baby girl’s thigh and attempt to wash out the deadly bacteria accumulating in her right femur and knee joint. We’re trying to learn the new routine and master a new language. The vocabulary is demanding. There are procedures, medications, devices and acronyms. Most are scary — wound vacuum, PICC (peripherally inserted central catheter), clinical failure of vancomycin, Methicillin-resistant Staphylococcus aureus (MRSA). The only one who seems to have any answers is the pediatric resident. Unfortunately, he’s nearly always wrong. Our trip into this alternate reality started on Ellie’s first day of seventh grade. “My knee hurts,” she says. Probably too much soccer and cross-country running, we think. The next day, her right knee has swelled to the size of a small pumpkin. OK, that’s a little alarming. We visit the local emergency room. They suggest an ACL tear, send her home with a knee brace and order an MRI the next day. When we show up for the MRI, Ellie is definitely not herself. She’s quiet an...
Source: Thrive, Children's Hospital Boston - Category: Pediatrics Authors: Tags: All posts MRSA PICC line Source Type: news

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Authors: Tavares Paes Barreto AC, Rangel da Rocha Paschoal AC, Barbosa Farias C, Gomes Nogueira Borges PS, Gonelli Albanez da Cunha Andrade R, de Orange FA Abstract INTRODUCTION: Anesthesia emergence delirium (AED) is a self-limiting clinical phenomenon very common in children. Although pathophysiology is still uncertain, some factors seem to be involved, such as rapid awakening in an unknown environment, agitation during anesthetic induction, preoperative anxiety, environmental disorders, use of preanesthetic medication, use of inhalational anesthetics, and postoperative pain. OBJECTIVE: To determine the preva...
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
Jean-Martin Charcot (1825-1893), a member of the Facult é de Médicin at the famous Hôpital Salpêtrière in Paris, a neurologist and professor of anatomic pathology, in 1877 brought attention to the “maladies du foie et des voie biliare”1 and the entity of “fièvre intermittente hépatique” characterized by the triad of jaundice, right upper q uadrant pain, and fever, which came to be one of his eponymous legacies. This condition later became known as ascending cholangitis, based on the belief that infection always ascended from the duodenum through an inco...
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Source: Topics in Pain Management - Category: Anesthesiology Tags: Continuing Education Activity Source Type: research
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Source: Topics in Pain Management - Category: Anesthesiology Tags: CE Quiz Source Type: research
Summary We investigated the association of pre‐operative activity, reported by the Duke Activity Score Index, Short Form‐12 and measured by an accelerometer worn at home, with five cardiopulmonary exercise variables: peak power; peak oxygen consumption; anaerobic threshold; and ventilatory equivalents for oxygen and carbon dioxide. Fifty patients scheduled for major surgery underwent a standard pre‐operative cardiopulmonary exercise test and wore a chest‐mounted triaxial accelerometer for a mean (SD) duration of 3.2 (0.4) days. The Duke Activity Score Index and six accelerometer variables were significantly co...
Source: Anaesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
Authors: Wenande E, Erlendsson AM, Haedersdal M Abstract Fractional laser-assisted drug delivery (LADD) is increasingly finding its way into clinical practice as a new means to enhance topical drug uptake and improve treatment of cutaneous disorders. To date, LADD has been used for a wide range of conditions, including photodamaged skin, neoplastic lesions, scars, cutaneous infections, and vitiligo as well as for topical anesthetic and aesthetic procedures. Substantiated by randomized controlled clinical trials, strong evidence is available for LADD's usefulness for photodynamic therapy (PDT), for which improved ef...
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Conclusions: Patients with MPNs are more likely to report physical symptom bother than to report no bother with multiple physical problems on the DT&PL. Patients of minority race/ethnicity and those with PV, however, showed heightened prevalence of physical problems-characteristics which may be used to triage patients for more intensive symptom management. PMID: 29223988 [PubMed - in process]
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Day surgery continues to increase in popularity--but along with this trend has come increases in the risk of patient harm and the possibility of litigation.BJA Education
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