Anesthesiology
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Assessment of clinical competence is essential for residency programs and should be guided by valid, reliable measurements. We implemented Baker's Z-score system, which produces measures of traditional core competency assessments and clinical performance summative scores. Our goal was to validate use of summative scores and estimate the number of evaluations needed for reliable measures. ⋯ The Baker system produced moderately reliable measures at our institution, suggesting that it may be generalizable to other training programs. Raw absolute scores required few assessment occasions to achieve 90% reliable measurements.
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Diabetes impairs the cardioprotective effect of volatile anesthetics, yet the mechanisms are still murky. We examined the regulatory effect of isoflurane on microRNA-21, endothelial nitric-oxide synthase, and mitochondrial respiratory complex I in type 2 diabetic mice. ⋯ Failure of isoflurane cardiac preconditioning in obese type 2 diabetic db/db mice is associated with aberrant regulation of microRNA-21, endothelial nitric-oxide synthase, and mitochondrial respiratory complex I.
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The aim of this retrospective analysis was to evaluate the clinical effectiveness of the supraclavicular ultrasound-guided cannulation of the brachiocephalic vein in preterm infants. ⋯ This supraclavicular, in-plane, real-time, ultrasound-guided cannulation of the brachiocephalic vein seems to be a convenient and effective method to insert central venous catheters in preterm infants.