To evaluate the tool, mean FGF between surgical incision and the end of procedure was compared in four phases: (1) a baseline period before instituting decision rules, (2) Intervention-1 when decision support to reduce FGF was applied, (3) Intervention-2 when the decision
rule to reduce flow was deliberately inactivated, and (4) Intervention-3 when decision rules were reactivated.\n\nResults: The mean +/- SD FGF reduced from 2.10 +/- 1.12 l/min Compound Library (n = 1,714) during baseline to 1.60 +/- 1.01 l/min (n = 2,232) when decision rules were instituted (P < 0.001). When the decision rule to reduce flow was inactivated, mean FGF increased to 1.87 +/- 1.15 l/min (n = 1,732) (P < 0.001), with an increasing trend in FGF of 0.1 l/min/month (P = 0.02). On reactivating the decision rules, the mean FGF came down to 1.59 +/- 1.02 l/min (n = 1,845). Through the Smart Anesthesia Messenger T system, the authors saved 9.5 l of sevoflurane, 6.0 l of
desflurane, and 0.8 l isoflurane per month, translating to an annual savings of $104,916.\n\nConclusions: Real-time notification is an effective way to reduce inhalation agent usage through decreased excess FGFs.”
“Mycobacterium marinum is a non-tuberculous photochromogenic mycobacterium, commonly responsible for fish and amphibious infections world-wide. Contagion 17DMAG in humans typically follows minor hand trauma from aquarium keeping and manifests as a granulomatous infection of the skin. Dissemination is rare and almost exclusive to immunosuppressed hosts. 15 cases
of M. marinum fish tank related infection are hereby reported. The site of infection was the upper limbs in all cases. 3 patients presented a single papulo-verrucous lesion, while the Mizoribine remaining 12 showed a sporotrichoid clinical pattern. Diagnosis was reached by history and clinical examination and further supported by one or more of the following criteria: histology, culture, acid fast bacilli identification from histologic specimen and PCR. 2 to 3 months minocycline treatment showed efficacy in 13 individuals, another case was treated with rifampicin-isoniazid association, yet another showed spontaneous regression over a 3 month period.”
“We report a case of transcatheter valve-in-valve therapy performed on an 85-year-old man with severe mitral bioprosthetic valve dysfunction. He was a high risk candidate for conventional surgery and he underwent placement of the Melody transcatheter heart valve into the mitral bioprosthesis via the right femoral vein.(c) 2012 Wiley Periodicals, Inc.”
“Objective: Cardiopulmonary bypass (CPB) using a closed circuit system with minimal priming volume can be a solution to ameliorate adverse effects of CPB.