Patients with persisting exercise limitation after COVID infection show reduction in peak VO2 from peripheral rather than central cardiovascular limitation.
Long COVID shows evidence of immunological dysfunction persisting even 8 months after acute recovery.
Patient was IgE positive to both morphine & pholcodine...
As of February 28th 2023, pholcodine has FINALLY been banned in Australia by the Therapeutic Goods Administration (TGA).
Press release here: TGA - Pholcodine
It's very sad that it took 14 years after Florvaag & Johansson's landmark 2009 paper describing the connection between pholcodine and NMBD anaphylaxis, for this problem to be addressed.
How many patients were exposed to avoidable harm?
The pressure to practice truly patient-focused, evidence-based medicine weighs on every anaesthetist and anaesthesiologist. Yet as the volume of evidence has grown, so has the expectation to always provide the highest quality care.
There is a trap of unknown knowns: evidence known in the greater medical-knowledge body but that we are naively ignorant of.
Bastardising William Gibson (1993), we risk that the evidence:
“…is already here – it's just not very evenly distributed.”
The greatest challenge for evidence-based anaesthesia continues to be the translation of research findings into actual practice change. The key to this is the intersection between quality, personal relevance, general significance, and credibility. But how can we achieve this?
50% of retracted anesthesiology papers are retracted because of fraud, and 30% because of inadequate ethics approval.
90% of fraudulent papers in perioperative medicine retracted over the last 30 years were authored by only six researchers.
Carlisle investigated the distribution of independent variables between study groups in Fujii's fraudulent research:
"The published distributions of 28/33 variables (85%) were inconsistent with the expected distributions, such that the likelihood of their occurring ranged from 1 in 25 to less than 1 in 1 000 000 000 000 000 000 000 000 000 000 000 (1 in 1033), equivalent to p values of 0.04 to < 1 × 10-33 , respectively."
"It usually comes as a surprise to students to learn that some (perhaps most) published articles belong in the bin, and should certainly not be used to inform practice." – Greenhalgh.
Videolaryngoscopy is associated with improved glottic view, less failed attempts and fewer complications.