Drs. Shannon Smith, Jennifer Gewandter, Robert Dworkin, and colleagues have published an article entitled “Participant preferences for pharmacologic chronic pain treatment trial characteristics: an ACTTION adaptive choice-based conjoint study”.
Recruiting participants is one of the largest impediments to clinical trial completion. In this study of individuals with chronic pain, we used a computerized adaptive survey to evaluate preferences regarding 8 researcher-modifiable pain treatment trial characteristics . Understanding these preferences may allow investigators to choose clinical trial methods that boost enrollment, potentially increasing the speed with which new analgesic medications can be evaluated.
Robert H. Dworkin, PhD, is serving as Co-Chair of the Federal Pain Research Strategy working group on the “Transition from Acute to Chronic Pain.” This is one of five working groups that are developing a strategic plan for pain research across multiple federal agencies (e.g., NIH, FDA, CDC, VA) with the ultimate goal of enhancing the federal research agenda to relieve pain and improve evidence-based patient care. The “Transition from Acute to Chronic Pain” working group will provide recommendations for research targeting neurobiologic and psychosocial mechanisms of the transition from acute pain to the development of chronic pain.
This review evaluates the content and content validity of the existing measure for 3 commonly studied peripheral neuropathy conditions (diabetic, chemotherapy, and HIV neuropathy) in order to help researchers evaluate which measure would be most useful for their studies as well as serve as a basis for optimizing a current measure or creating a new one. Jennifer S. Gewandter, Laurie Burke, Guido Cavaletti, Robert H. Dworkin, Christopher Gibbons, Tony D. Gover, David N. Herrmann, Justin C. McArthur, Michael P. McDermott, Bob A. Rappaport, Bryce B. Reeve, James W. Russell, A. Gordon Smith, Shannon M. Smith, Dennis C. Turk, Aaron I. Vinik, Roy.
Dr. Peter Papadakos published an article, "The Rise in Bogus Science - The Explosion of Predatory Journals" in the Quarterly Newsletter of the Society of Neurocritical Care Currents, Vol. 11, No. 2. Dr. Papadakos is an advocate in bringing the explosion of questionable for-profit medical journals to light. They are a danger to the integrity of medical science.
Dr. Gewandter and co-authors, including past anesthesiology residents Drs. Hoang and Rothstein and current and future pain fellows Drs. Kralovic and Iwan published a systematic review in PAIN. The review identified deficiencies in reporting of analgesic clinical trials with cross-over designs. It provides recommendations for the details that should be included in primary publications of cross-over trials to ensure readers’ ability to critically evaluate the results, use the data in meta-analyses, and plan future trials.
Jennifer S. Gewandter, Michael P. McDermott, Andrew McKeown, Kim Hoang, Katarzyna Iwan, Sarah Kralovic, Daniel Rothstein, Ian Gilron, Nathaniel P. Katz, Srinivasa N. Raja, Stephen Senn, Shannon M. Smith, Dennis C. Turk, Robert H. Dworkin. Reporting of cross-over clinical trials of analgesic treatments for chronic pain: ACTTION systematic review and recommendations.
July 13, 2016
Dr. David Lyons has received the 2016 Ronald A. Gabel, MD Award for Teaching Excellence, announced at the Resident Graduation Party on Saturday, June 18. The award, named in honor of Dr. Gabel, former Chair of the Department, recognizes excellence in clinical or didactic teaching and deems the individual upholds the highest of personal ethical standards, including integrity, fairness, and respect and compassion for others.
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July 12, 2016
Two abstracts from our Department were chosen as the top six abstracts for oral presentation at the Society for Education in Anesthesia’s annual meeting in Baltimore, MD on June 4, 2016. The first authors of the abstracts were Dr. Kaitlyn Mitchell and Dr. Colin Sheehan.
Dr. Sheehan presented a new safety and quality program at URMC entitled, “Implementation of the Safety Program at the Institutional Level: Difficult Airway Response Team (DART) Program”. Dr. Kaitlyn Mitchell presented, “Educational Innovation in Difficult Airway Management: Multidisciplinary Difficult Airway Course” and was awarded the second best abstract in the innovative curriculum category. Both were mentored by Dr. Zana Borovcanin.
Congratulations to Kaitlyn and Colin!
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July 11, 2016
Dr. Lynnie Correll has received the 2016 Resident Teacher of the Year Award, announced at the Resident Graduation Party on Saturday, June 18. The recipient of the award is chosen by the medical students, and is based on their evaluations of the resident who has had the most impact on teaching the ANS 601 course.
Congratulations, Dr. Correll!
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June 29, 2016
Dr. Andrew Wojtovich and colleagues have had their manuscript, “Dihydromunduletone is a Small-Molecule Selective Adhesion G Protein-Coupled Receptor Antagonist”, accepted for publication in the journal, Molecular Pharmacology. Hannah M. Stoveken, Laura L. Bahr, M.W. Anders, Andrew P. Wojtovich, Alan V. Smrcka, and Gregory G. Tall, DOI: 10.1124/mol.116.104828.
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June 20, 2016
At the recent meeting of the World Institute of Pain (May 20-23, 2016; New York City), Robert Dworkin, PhD, delivered a plenary lecture on “Toward an evidence-based approach to the design of clinical trials” and a second presentation on “Beyond NNTs: Have pain treatment guidelines neglected safety and tolerability?”
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June 9, 2016
Janet Pennella-Vaughan, NP was awarded the University of Rochester Nurse Practitioner of the Year Award on May 9, 2016 during celebration of National Nurses’ Week.
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June 1, 2016
Dr. Ellen Dailor has been selected to participate in the University’s Senior Leader Education and Development Program (SLED). The program is a two-year educational leadership development program created to provide leadership development opportunity for URSMD faculty in senior leadership positions. It is designed to foster practical knowledge from recognized theoretical models and best practices.
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June 1, 2016
Dr. Peter Papadakos has been named Co-Chair of the Society of Neurocritical Care Advocacy Committee. The committee is responsible for the public face of the society making the case to patients, the public, policy makers and other healthcare professionals that complex, life-threatening neurological diseases are best cared for by a multidisciplinary team with special expertise in neurocritical care. He has also been appointed to serve on the branding task force. The Society of Neurocritical Care is the largest international society in the field of the care of critical ill neurosurgery and neurology patients. Dr. Papadakos also serves as an editor for the Society’s Journal Neurocritical Care.
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May 31, 2016
Robert Dworkin, PhD, Director of the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the FDA presented overviews of ACTTION’s activities at recent meetings of the Measures for Justice Institute (April 10-11, 2016, Rochester, NY), Pediatric Anesthesia and Neurodevelopment Assessment (PANDA) Study and SmartTots public-private partnership (April 16-17, 2016, Columbia University), and Evolution Summit for Best Practices in North American Clinical Trials (May 9-11, 2016, Palm Beach, FL).
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May 26, 2016
Aspiring student entrepreneurs presented their business models to a panel of judges during the 10th annual Mark Ain Business Model Competition. This year 18 interdisciplinary teams of 60 students submitted applications to the competition. Second Place went to StimSense, which offers a medical device that objectively quantifies depth of anesthesia throughout surgery to guide proper dosing, reduce post-operative complications and achieve better patient recoveries. The team consisted of Martin Gitomer, from Princeton, NJ; Alin Ponici, from Livingston, NJ; Shwe Pyie, from Union City, CA; and Jia Shi, from Shanghai, China. Their faculty mentor for the project was Dr. Michael Eaton.
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May 25, 2016
Drs. Daryl Smith and Anil Arekapudi lead a Problem Based Learning Discussion at the annual meeting of the International Anesthesia Research Society (IARS) in San Francisco, CA on May 21, 2016. The topic of their PBLD was: Use of Sympathetic Ganglion Blockade to Treat Ventricular Tachydysrhythmia: Clinical Indications, Techniques and Controversies.
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May 18, 2016
Dr. Laura McElroy provided anesthesia to patients who volunteered to be part of the 2nd Annual Advanced Endoscopy Nurses teaching course on 4/22 and 4/23 at the University, a very unique course and the only one of its kind in the U.S. The participants were from 7 different states including California. The overall course satisfaction rating was 97.5% with 96% saying they intended to return next year. The procedures were live broadcasted. This is the second year Dr. McElroy has helped with the course.
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May 17, 2016
Dr. Ellen Dailor recently had the privilege of being a speaker and panelist with the Cardiac Centre of Shisong at the 10th Scientific Congress of the Cameroonian Society of Cardiologists. The picture at top left includes a patient who is a student in Yaounde; she is less than 2 months post-op and came to the Congress to show support. The man in the picture is a cardiac surgeon and the other woman is the patient’s cardiologist in Yaounde.
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May 16 , 2016
Dr. Peter Papadakos is a member of the American Assoc. for Respiratory Care (AARC) and University HealthSystem Consortium’s (UHC) Respiratory Care Network Committee. They have generated a white paper, “Safe Initiation and Management of Mechanical Ventilation”, which provides guidance for best practices for safe initiation and management of mechanical ventilation. It helps define the competency, training, and interdisciplinary approach necessary for patient safety and improved outcomes.
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May 13, 2016
Drs. Andrew Wojtovich, Paul Brookes, PhD student, C. Owen Smith, and colleagues have published the article “Cardiac Slo2.1 Is Required for Volatile Anesthetic Stimulation of K+ Transport and Anesthetic Preconditioning”, in the May 2016 issue of Anesthesiology, Vol. 124, 1065-1076. Their article was also mentioned in ASAP, the weekly membership publication of the American Society of Anesthesiologists.
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May 13, 2016
Drs. Laurent Glance, Michael Eaton, Stewart Lustik, and colleagues have published the article “Outcomes are Worse in US Patients Undergoing Surgery on Weekends Compared with Weekdays” in Medical Care, 2016 Apr 22 [Epub ahead of print]. The authors concluded patients undergoing nonemergent major cardiac and noncardiac surgery on the weekends have a clinically significantly increased risk of death and major complications compared with patients undergoing surgery on weekdays. These findings should prompt decision makers to seek to better understand factors, such as physician and nurse staffing, which may contribute to the weekend effect.
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May 12, 2016
Dr. Ellen Dailor’s international missionary work in Cameroon was featured in the May 2016 issue of the Diocese of Rochester Catholic Courier in the Regional Life Section. Earlier this year, she logged a seven-week trip to Cameroon which marked her 7th volunteer visit to the West African country. In Cameroon she worked with other missionaries and a local medical team to perform desperately needed heart surgeries. “Most of the patients we operate on are at the point that they require surgery in order to survive,” Dailor said. She noted that a large percentage of her patients are young people with rheumatic heart disease caused by strep throat. She has been performing missionary service since 2001 and plans to continue ministering in Cameroon.
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May 11, 2016
Dr. Marjorie Gloff was one of the featured speakers at the 34th Annual Cam-Am Conference on May 7, 2016. Her talk, “The University of Rochester’s Journey to Establishing a Perioperative Surgical Home”, discussed a new and exciting concept that anesthesiologists can use to help engage patients early in their perioperative course; a way to ensure that each patient is cared for at the right time and the right place. The CPM is reaching out across departments to improve perioperative care of patients and some of these initiatives were addressed during her talk, including our Periop Anemia Optimization Clinic as well as the Periop Surgical Home for our Sawgrass Surgical Center.
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May 2, 2016
Dr. Peter Papadakos has received promotion to Professor of Anesthesiology with tenure. He also holds joint appointments as Professor of Neurosurgery, Professor of Surgery and Professor of Neurology.
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April 28, 2016
Drs. Laurent Glance, Michael Eaton, Stewart Lustik, and colleagues have published the article “Feasibility of Report Cards for Measuring Anesthesiologist Quality for Cardiac Surgery” in the May 2016 issue of Anesthesia & Analgesia. The authors concluded the impact of anesthesiologists on the total variability in cardiac surgical outcomes was probably about one-fourth as large as the surgeons’ contribution. None of the anesthesiologists caring for cardiac surgical patients in NYS over a 3+ year period were identified as performance outliers. The use of a performance metric based on death or major complications for pay for performance may not be feasible for cardiac anesthesiologists. (Anesth Analg 2016;122(5):1603-13)
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April 21, 2016
Drs. Shannon Smith, Jennifer Gewandter, Mark Williams and Robert Dworkin, along with their co-authors, have published a manuscript in Pain titled, “Pain intensity rating training: results from an exploratory study of the ACTTION PROTECCT system”.
This article reports on a study of a training protocol that involves specific, standardized guidance regarding how to rate daily average pain intensity. The goal of the training was to improve the validity and reliability of pain intensity ratings in pain treatment trials.
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April 14, 2016
Dr. Peter Papadakos article, “Digital Journals: The Real and The Predatory” was featured on the front page of the April 2016 issue of Anesthesiology News. He discusses the recent explosion of invitations to submit papers to online journals, some accepting and publishing the article before requiring several-thousand dollar processing fees upon publication.
“Another negative aspect of these journals is that patients may be getting false information when they Internet search on various diseases. The consumer has no safeguards to filter true versus false data and treatments.”
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April 13, 2016
MaryTherese Biltucci, RDH, MA, MS has published two online articles. The first, titled “Peer Learning in Higher and Medical Education A Literature Review”, explores peer learning (PL), peer tutoring (PT), and peer-assisted learning (PAL) as instructional strategies to increase the benefits of traditional learning in higher education, medical and graduate medical education.
The second, “Developing Residents as Teachers: Stage One – Instruction of Medical Students, Guides for Developing Small Group Teaching”, was co-authored by Drs. Suzanne Karan, Dierdre Cavan, Eric Faden, Duncan McLean, Kaitlyn Mitchell, Jagroop Saran, Zahraa Majeed, Lynnie Correll, Yang Gu, Nikolay Manuylov, Sean Philippo, and Colin Sheehan. The primary goal was to develop anesthesiology residents as educators with a secondary goal of changing the style of medical learning from lecture-based education to more active learning.
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April 12, 2016
Dr. Annie Philip was one of three pain physicians featured in an article in the April 8, 2016 Health and Lifestyle section of the Democrat & Chronicle titled, “A new approach to pain relief”.
She, along with colleagues, Dr. Calvin Chiang and Dr. John Markman, discuss the management of chronic pain, including the physical and mental aspects. Dr. Philip states, “We educate and empower patients to manage their pain. They can do it and they don’t need a lot of medication. When a patient really understands this, then they start to relax, and that’s when the healing happens.” Physical therapy is always recommended.
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March 24, 2016
Dr. Peter Papadakos discussed electronic distraction both during a podcast on Straight Talk MD (https://itunes.apple.com/us/podcast/straight-talk-md/id1060256849?mt=2 or via PC/Android at straighttalkmd.com). He also authored an article titled, “Distracted Outdoors” for the Spring 2016 issue of Localadk, which features local people of interest in the Adirondack Mountains.
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March 18, 2016
Dr. Suzanne Karan has published an editorial titled, “Gestational sleep apnea: have we been caught napping?” in the International Journal of Obstetric Anesthesia.
The article reviews what is known about OSA in pregnancy, as compared to the non-pregnant population, and comments on the disparities between what we can do and what we actually do in this cohort. Asked is why we are not doing more and concludes with the suggestion that there is need for a new diagnosis, “gestational sleep apnea”, to parallel other established transient diagnoses of pregnancy, like gestational hypertension and gestational diabetes mellitus.
March 1, 2016
Dr. Janine Shapiro has been elected to serve on the AAMC (Assoc. of American Medical Colleges) Council of Faculty and Academic Societies (CFAS) as the representative for the Society for Academic Continuing Medical Education.
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February 23, 2016
Dr. Suzanne Karan will serve on an American Society of Anesthesiologists (ASA) ad hoc committee on resident advocacy.
The focus of the ad hoc group will be to explore the opportunities that exist to bolster advocacy training in residents, allowing more latitude and freedom for academic faculty to openly train and educate residents on the essentials of advocacy for patients and the specialty.
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February 18, 2016
Dr. Peter Papadakos has been named editor for the book series, “Clinical Neurology: Best Practices” by Rutgers University Press. The books will be fairly concise, circa 150-250+ pages, edited by leading experts throughout the world in Neurology, Neurosurgery, and Critical Care.
This series is part of a new medical education initiative at Rutgers University Press, making it one of three university presses (the other two being Oxford and Cambridge) to provide major publishing opportunities in a not-for-profit environment.
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February 12, 2016
In the February 2016 issue of Anesthesiology News, Dr. Lynnie Correll is featured in the article “Dexmedetomidine Effective for Stapes Microsurgery and Saves OR Time”. Local anesthesia and sedation with dexmedetomidine (Precedex, Hospira) is more efficient and better tolerated than general anesthesia when conducting stapes surgery, according to a new study. The article quotes Dr. Correll, “We’re talking about a very delicate microsurgery within the ear. . .The difficulty is that having surgery in your ear hurts, and people move around a lot”, she explained during a poster presentation at the NYS Society of Anesthesiologists 69th Annual PostGraduate Assembly. . .”The goal is to potentially create a technique where the patient is awake enough to say, ‘I can hear now’, but they’re not wiggling all over the place, because the size of the bone. . .is only 3 mm.” The entire article can be found at AnesthesiologyNews.com.
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February 4, 2016
Featured in the latest issue of Rochester Medicine magazine, two of URMC’s leading experts on trauma care can now say they wrote the book on it too. Peter Papadakos, MD, Professor of Anesthesiology and Surgery, Neurosurgery and Neurology, and Mark Gestring, MD, Associate Professor of Surgery, Emergency Medicine, and Pediatrics, are co-editors of the Encyclopedia of Trauma Care, released by Springer Publishing fall of 2015. The two-volume, 1,801-page manual includes contributions from 48 URMC physicians and doctors around the world. In encyclopedic format, readers can rapidly thumb through practical, up-to-date information on major topics in trauma management. In addition to providing information on a range of organ-specific injuries, the manual’s topics include critical care of the trauma patient, trauma system organization, mass injury scenarios, the impact of new technologies, complications in trauma care, and ethical issues.
January 19, 2016
Dr. Jacek Wojtczak1, Christopher Brown, PhD2 and Bo Hu, PhD2 have been issued U.S. Patent #9,230,325 B2 for “Three-Dimensional Model Acquisition Using Planar Mirrors”.
3-D model acquisition of an object is performed using two planar mirrors and a camera. According to some embodiments, 3-D reconstruction is achieved by recovering the scene geometry, including the equations of the mirrors, the camera parameters and the position of the markers, which give the location and orientation of the subjects. After establishing the geometry, a volume intersection algorithm is applied to build a 3-D model of the subject. Camera parameters and spatial constraints of the mirrors may be initially unknown. Camera parameters may be solved with reference to the object and references in the object. Further, distance from the camera to at least one point on the object may be determined once camera parameters are solved. Markers having fixed relative positions may be provided on the object for reference.
1 Dept. of Anesthesiology 2 Department of Computer Science
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January 12, 2016
Dr. Peter J. Papadakos and his wife, Dr. Susan Dantoni, edited a volume of the Critical Care Clinics entitled, “Obstetric and Gynecologic Emergencies”. The book contains contributions from several former faculty and fellows along with current faculty: Dr. Albert Yu, Dr. Anna Kaminski, Dr. Ari Balofsky, Dr. Marcin Karcz, Dr. Amie Hoefnagel, Dr. Max Fedarau and former resident, Dr. Huayong Hu. The book also has contributions from colleagues in the Department of OB/GYN at the University of Rochester along many other international and national experts.
January 8, 2016
Dr. Ari Balofsky and Dr. Peter Papadakos have authored a chapter in the book, Noninvasive Mechanical Ventilation and Difficult Weaning in Critical Care, published by Springer. The chapter (pp 37-41) is titled, "Recommendations of Sedation and Anesthetic Considerations During Weaning from Mechanical Ventilation".
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January 7, 2016
Dr. Mark Williams and colleagues, including Dr. Robert Dworkin, have published a Review Article in the January 2016 issue of Anesthesia & Analgesia, titled “Efficacy Outcome Measures for Procedural Sedation Clinical Trials in Adults: An ACTTION Systematic Review”. AnesAnalg 2016:122(1); 152-170
Please view the abstract here, and like this story on Facebook.
January 6, 2016
Dr. Peter J. Papadakos served as faculty at the United States Naval Sea Cadet Corps Emergency Medicine Seminar New England, Class 4 at Naval Station Newport, Rhode Island. He was proud to teach 40 highly motivated young people to become Corpsman for their units from around the country. The training was under the command of Lt. Commander David Hull, an outstanding educator and leader.
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December 16, 2015
Dr. Peter Papadakos presented a national patient safety webinar sponsored by AHRQ (Agency of Health Care Research and Quality) and the Society of Critical Care Medicine entitled, “Electronic Distraction in the ICU: An Impediment to Patient Safety”.
December 16, 2015
Dr. Laurent Glance has published two articles, one in the Annals of Surgery titled, “Impact of Risk Adjustment for Socioeconomic Status on Risk-adjusted Surgical Readmission Rates”, and the second in Medical Care titled, “Disparities in 30-Day Rehospitalization Rates Among Medicare Skilled Nursing Facility Residents by Race and Site of Care”. (Ann Surg. 2015 Dec 10. [Epub ahead of print], PMID: 26655922; Med Care. 2015 Dec;53(12):1058-65. PMID: 26492217)
Please view the articles in the Annals of Surgery and Medical Care.
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December 8, 2015
Dr. Peter Papadakos published the study guide to the New York Times best seller, "A Deadly Wandering", by Pulitzer Prize winner, Matt Richtel, and published by Harper Collins. The text is widely used in teaching teens and college students the dangers of distracted driving and has had a major impact on public safety. One of the year's most original and masterfully reported books, "A Deadly Wandering" interweaves the cutting-edge science of attention with the tensely plotted story of a mysterious car accident and its aftermath to answer some of the defining questions of our time: What is technology doing to us? Can our minds keep up with the pace of change? How can we find balance? Through Richtel's beautifully constructed narrative, a complex and far-reaching topic becomes intimate and urgent - an important call to reexamine our own lives. Over the last number of years, Dr. Papadakos has become a recognized international expert in Electronic Distraction in healthcare.
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Dr. Papadakos Invited Speaker at Ecuador Conference
December 8, 2015
Dr. Peter Papadakos was an invited speaker at II Simposio Internacional De Cuidados Neurocriticos E Investigacion Clinica at the Auditorio Centro Cultural, Pontificia Universidad Catolica del Ecuator in Quito, Ecuador, Nov. 23-25. His four lectures were titled, "The Physiology of Mechanical Ventilation", "New Frontiers in Sedation", "Non-Invasive Ventilation in the Neuro-ICU", and "Neurological Complications in Pregnancy". In addition, Dr. Papadakos has been asked to consult on the development of Neuro Critical Care in Ecuador in collaboration with Universidad San Francisco de Quito School of Medicine on respiratory therapy in Latin America. While he was at the conference, he also toured Hospital Metropolitano, a state of the art medical center in Ecuador.
Dr. Karan co-author in Journal for Graduate Medical Education
December 7, 2015
Dr. Suzanne Karan is a co-author with Drs. Jeffrey Berger and Michael Wajda on an article entitled "Confessions of Physicians: What Systemic Reporting Does Not Uncover". This new approach to resident conversation attempts to overcome the stigma of reporting and discussing incidents and situations that negatively affect the quality and safety of care.
Please view the article here.
Dr. McLean co-author in British Medical Journal Article
December 3, 2015
Dr Duncan J. McLean is co-author with Drs. Ladha, Vidal Melo, Wanderer, Grabitz, Kurth and Eikermann on a manuscript entitled “Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study”. In this study, 69,265 patients from three hospitals were enrolled over a 7-year period, comparing lung-protective ventilation with non-protective ventilation. Lung-protective ventilation, defined as positive end-expiratory pressure of 5cm H2O and plateau pressures of 16cm H2O or less, was associated with a decreased risk of postoperative respiratory complications.
Please view the article here.
Drs. Franklin and Papadakos Publish in Anesthesiology News
October 29, 2015
Drs. Keith Franklin and Peter Papadakos published a Supplement for the October 2015 issue of Anesthesiology News entitled, “Perioperative Management of Hypertension”. The article covers the common issues of hypertension and reviews the common pharmacologic agents.
Please view the article here.
Dr. Robert Dworkin Delivers Endowed Lecture
October 29, 2015
Dr. Robert Dworkin delivered the C. Paul Perry Memorial Lecture at the annual meeting of the International Pelvic Pain Society in San Diego, CA on Friday, Oct. 23, 2015. The title of the lecture was “From Clinical Trials to Clinical Practice: There’s Many a Lip ‘Twixt Cup and Lip”, and it focused on false positive and negative clinical trial outcomes and their implications for the development of treatment guidelines.
Dr. Borovcanin Abstracts Accepted for World Airway Management Mtg. in Dublin
October 29, 2015
Dr. Zana Borovcanin has two abstracts accepted for oral presentation at the World Airway Management Meeting in Dublin, Ireland November 12-14, 2015. The first abstract, co-authored with Dr. Janine Shapiro and Oren Harary, is entitled “Difficult Airway Response Team Program at the University of Rochester: Adaption of the Johns Hopkins Medicine DART Program to Improve Patient Outcomes. The second abstract, co-authored with Drs. Janine Shapiro and Anna Kaminski, is titled, “Multidisciplinary Difficult Airway Course – Innovation in Airway Education”.
October 16th, 2015
Dr. Peter Papadakos received the 2015 Presidential Citation by the Neurocritical Care Society at their annual meeting in Scottsdale, AZ Oct. 8th. He received the award for his service to the Society and his contributions to the field of neurocritical care.
With a worldwide membership of multi-professional health care providers, the Neurocritical Care Society is dedicated to improving the health care and outcomes of patients with life-threatening neurological illnesses by promoting quality patient care, professional collaboration, research, training and advocacy.
October 13th, 2015
Dr. Ahmed Khan and colleagues have published an article in the journal Annals of Cardiac Anaesthesia titled, “Anti-inflammatory effects of propofol during cardiopulmonary bypass: A pilot study”. Propofol has been suggested as a useful adjunct to cardiopulmonary bypass (CPB) because of its potential protective effect on the heart mediated by a decrease in ischemia-reperfusion injury and inflammation at clinically relevant concentrations. In view of these potentially protective properties, which modulate many of the deleterious mechanism of inflammation attributable to reperfusion injury and CPB, the authors sought to determine whether starting a low dose of propofol infusion at the beginning of CPB would decrease inflammation as measured by pro-inflammatory markers. Result: The most significant difference was in the level of IL-6 which had a P value of less than 0.06. Starting a low dose propofol early during the CPB was not associated with significant hemodynamic instability in comparison with the control group. Conclusion: The study shows that propofol may be suitable as an anti-inflammatory adjunct for patients undergoing CABG.
Samir A, Gandreti N, Madhere M, Khan A, Brown M, Loomba V. Anti-inflammatory effects of propofol during cardiopulmonary bypass: A pilot study. Ann Card Anaesth 2015;18:495-501.
October 7th, 2015
Dr. Peter Papadakos was an invited speaker at the National Focus Conference, Desmond Hotel and Conference Center, Albany, NY on September 29th. He presented three lectures: Management of Pulmonary Hypertension, Ventilation in Severe Trauma, and Electronic Distraction of Allied Health Professionals.
He also spoke at the 35th Annual NYSSRC Symposium at the Turning Stone Resort and Convention Center in Verona, NY on October 1st. His lecture was, “Electronic Distraction of the RT: We must make the patient first”.
August 25th, 2015
Dr. Peter Papadakos has published the "Encyclopedia of Trauma Care". This encyclopedia is an authoritative compilation of practical information on major topics in trauma management. Its encyclopedic format will allow the reader to rapidly find up-to-date information on a specific topic of interest. The book is organized in an organ-based manner for ease of use when a practitioner is confronted with a particular injury. Each chapter takes the form of a clearly structured review of the subject in question and includes informative illustrations and tables as well as lists of classic references. In addition to the full range of organ-specific injuries, a number of important further topics are covered, including critical care of the trauma patient, trauma system organization, mass injury scenarios, the impact of new technologies, complications in trauma care, and ethical issues. All of the authors are leading experts, and the encyclopedia will provide an excellent source of information for both basic and clinical scientists and trainees in various fields.
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August 24th, 2015
Dr. Janine Shapiro was elected to serve on the Accreditation Council for Continuing Medical Education (ACCME) Accreditation Review Committee. The ACCME is responsible for accrediting institutions that offer CME to physicians and other healthcare professionals. Dr. Shapiro also serves the national Continuing Medical Education community through her roles as a member of the Steering Committee of the Association of American Medical Colleges (AAMC) Group on Educational Affairs Section on Continuing Education and Improvement, and as a member of the AAMC Joint Working Group with the Society of Academic Continuing Education (SACME).
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July 29th, 2015
Dr. Peter Papadakos was quoted extensively in an article in Healthline News titled, “Do Cell Phones Spread Infections in Hospitals?” The article discusses the use of cell phones in the OR by medical staff and the risk of infection they potentially can cause and policies that are now just being discussed to address this growing concern.
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July 16th, 2015
In the July 13, 2015 Washington Post Health & Science Section, Dr. Peter Papadakos was quoted in an article "Do cellphones belong in the operating room?". It cites the University of Rochester Medical Center addressing the issue by requiring staff to keep phones silenced when working with patients and forbids using phones for personal matters while at any "clinical work stations", not just operating rooms.
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July 9th, 2015
Dr. Jacek Wojtczak has 4 presentations that have been accepted for the October 2015 American Society of Anesthesiologists meeting, titled, “Preoperative Prediction of Difficult Intubation: Sonographic Assessment of Tongue and Oral Cavity Dimensions”; “Mini Ultrasound Systems for the Point-of-Care Lung Sonography: A Useful New Tool?”; “Echogenic Endotracheal Tubes and Laryngeal Mask Airways: A Reality?”; and “Airway Dimensions: External Landmarks and Internal Structures Comparison”.
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July 8th, 2015
Resident Dr. Duncan McLean was featured in the hospital-wide Patient Safety Grand Rounds: "YoUR Support: Staff Emotional Support After Critical Incidents" on June 29th, 2015.
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July 6th, 2015
Dr. Sonia Pyne was featured in Hot jobs in the June 27, 2015 edition of the Democrat & Chronicle. The article, titled, “Meet UR anesthesiologist, Dr. Sonia Pyne”, details an anesthesiologist’s responsibilities, preparation for the position, and quotes Dr. Pyne’s assessment of her role during surgery and her background. To read the full article: please go to the Democrat and Chonicle website.
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June 24th, 2015
Dr. Laurent Glance has been selected to the Associate Editorial Board of Anesthesiology effective Jan. 1, 2016. In his congratulatory notification, Dr. James Eisenach, Editor-in-Chief of Anesthesiology, states that Dr. Glance is “simply one of the best and brightest in our specialty, and your accomplishments in scholarly activity and leadership were every bit as important as your work for the Journal in our selection”. Congratulations!
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June 23rd, 2015
Dr. Peter Papadakos and members of the ASA Safety Committee have had a presentation accepted for the October ASA meeting titled, “Personal Electronic Device Use in the Operating Room: A Survey of Usage Patterns, Risks, and Benefits”. Other authors include Dr. Roy Soto, Dr. Sara Neves, and Dr. Fred Shapiro.
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June 23rd, 2015
Dr. Peter Papadakos’ commentary, “Put the Phone Away, You Are Having an Operation” was featured on the front page of the June 2015 issue of Anesthesiology News. The article addressed the rise in patients and families not paying attention to health providers and also discusses that patients need to be educated to know their health problems and medications.
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June 17th, 2015
Drs. Marcin Karcz and Peter Papadakos , with colleagues in Germany and the Netherlands, have published the Review Article, “Lung recruitment in trauma patients”, in Global Anesthesia and Perioperative Medicine. The purpose of the article is to review the major concepts in the mechanical ventilation literature that outline the principles for the use of the open lung management strategy in patients that have been subjected to significant trauma and to delineate both the major techniques of lung recruitment as well as their potential complications. Glob Anaesth Perioper Med, 2015; Vol. 1(3):76-81.
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June 11th, 2015
Dr. Ashwani Chhibber has been named Chief of Anesthesiology for the new Golisano Children’s Hospital tower set to open in July 2015. He is Professor of Anesthesiology and Pediatrics and Chief of the Division of Pediatric Anesthesiology.
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June 9th, 2015
Drs. Michael Eaton, Dawn Sweeney, and colleagues have published a paper titled, “Pharmacokinetics of e-Aminocaproic Acid in Neonates Undergoing Cardiac Surgery with Cardiopulmonary Bypass”, in the May issue of Anesthesiology. Antifibrionolytic medications such as e-aminocaproic acid (EACA) are used in pediatric heart surgery to decrease surgical bleeding and transfusion. Dosing schemes for neonates are often based on adult regimens, or are simply empiric, in part due to the lack of neonatal pharmacokinetic information. The authors sought to determine the pharmacokinetics of EACA in neonates undergoing cardiac surgery and to devise a dosing regimen for this population. Ten neonates undergoing cardiac surgery with cardiopulmonary bypass were given EACA according to standard practice, and blood was drawn at 10 time points to determine drug concentrations. Time-concentration profiles were analyzed using nonlinear mixed effects models. Parameter estimates (standardized to a 70-kg person) were used to develop a dosing regimen intended to maintain a target concentration shown to inhibit fibrinolysis in neonatal plasma (50 mg/l). Conclusions: EACA clearance, expressed using allometry, is reduced in neonates compared with older children and adults. Loading dose and infusion dose are approximately half those required in children and adults. Anesthesiology 5 2015, Vol.122,1002-1009
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June 8th, 2015
Dr. Peter Papadakos has been asked to serve as a member of the Steering Committee to develop a course, Fundamental Respiratory Care Support Course (FRCSC), by the International Council for Respiratory Care (ICRC). Ultimately the project is designed to produce a training course intended for implementation outside of the United States for health providers not experienced in Respiratory Care. This project will greatly impact on the care of patients with respiratory diseases throughout the developing world. Dr. Papadakos has had a long career in the management of mechanical ventilation in the ICU and is an internationally known expert in the field and has contributed greatly with both basic and clinical research and as an author of two texts in the field. He is honored to join peers from all the corners of the globe to develop international standards in the care of these patients.
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May 23rd, 2015
Dr. Suzanne Karan's article, “Confessions of Doctors: What Systemic Reporting Does Not Uncover” has been accepted for publication in the Journal of Graduate Medical Education.
May 23rd, 2015
Dr. Laurent Glance and colleagues have published an article that is being highlighted in the May issue of JAMA Surgery with an accompanying editorial. Titled, “Survival Rates in Trauma Patients Following Health Care Reform in Massachusetts”, the objective was to examine the effect of Massachusetts health care reform on survival rates of injured patients. Turner Osler, MD, MSC, Laurent G. Glance, MD, Wenjun Li, PhD, Jeffery S. Buzas, PhD, David W. Hosmer, PhD, JAMA Surg. Published online May 6, 2015. Doi:10.1001/jamasurg.2014.2464
Design, Setting and Participants: Retrospective cohort study of 1,520,599 patients hospitalized following traumatic injury in Massachusetts or New York during the 10 years (2002-2011) surrounding Massachusetts health care reform (HCR) using data from the State Inpatient Databases. The authors assessed the effect of HCR on mortality rates using a difference-in-difference approach to control for temporal trends in mortality. Results: During the 10-year study period, the rates of uninsured trauma patients in Massachusetts decreased steadily from 14.9% in 2002 to 5.0% in 2011. In New York, the rates of uninsured trauma patients fell from 14.9% in 2002 to 10.5% in 2011. The risk-adjusted difference-in-difference assessment revealed a transient increase of 604 excess deaths (95% CI, 419-790) in Massachusetts in the 3 years following implementation of HCR. Conclusions and Relevance: Health care reform did not affect health insurance coverage for patients hospitalized following injury but was associated with a transient increase in adjusted mortality rates. Reducing mortality rates for acutely injured patients may require more comprehensive interventions than simply promoting health insurance coverage through legislation.
May 6th, 2015
Dr. Laurent Glance has co-authored a paper with Drs. Osler, Li, Buzas, Wetzel and Hosmer, titled “Trauma care does not discriminate: The association of race and health insurance with mortality following traumatic injury”, in the May issue of the Journal of Trauma and Acute Care Surgery. Previous studies have reported that black race and lack of health insurance coverage are associated with increased mortality following traumatic injury. However, the association of race and insurance status with trauma outcomes has not been examined using contemporary, national, population-based data. The authors used data from the National Inpatient Sample of 215,615 patients admitted to 1 of 836 hospitals following traumatic injury in 2010. They examined the effects of race and insurance coverage on mortality using two logistic regression models, one for patients younger than 65 years and the other for older patients. The conclusion reached is that black race is not associated with higher mortality following injury. Health insurance coverage is associated with lower mortality, but this may be the result of hospitals’ inability to quickly obtain insurance coverage for uninsured patients who die early in their hospital stay. Increasing insurance coverage may not improve survival for patients hospitalized following injury. (J Trauma Acute Care Surg. 2015;78: 1026-1033)
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May 5th, 2015
Dr. Peter Papadakos has been named to the Joint Taskforce on a White Paper regarding Safe Initiation and Management of Mechanical Ventilation of the University Hospital System Coalition UHC. The objectives of the taskforce are: to provide guidelines for the initiation and management of mechanical ventilation to improve patient care and safety, and for the minimal training and competencies needed to effectively manage patients of mechanical ventilation, to highlight the need for in-depth knowledge required to safely initiate and manage patients on mechanical ventilation including adjusting appropriate alarm settings with each adjustment, to emphasize the benefit that RT brings to the interdisciplinary team regarding ventilation and its effect on patient outcomes, to establish importance of interdisciplinary communication on patient outcomes, to set guidelines to ensure that there is timely and accurate documentation of initiation and subsequent adjustments and their effect on the patient, and to highlight the need for written or electronically signed physician orders for each adjustment unless covered under established protocol.
Dr. Papadakos contributes nationally and internationally to mechanical ventilation and the education of health professionals, physicians, mid-levels, and RT’s in ventilator support of patients.
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April 30th, 2015
Dr. Duncan J. McLean is first author with Drs. Diaz-Gil, Farhan, Ladha, Kurth and Eikermann on a manuscript entitled: “Dose-dependent association between intermediate-acting neuromuscular-blocking agents and post-operative respiratory complications.” In this study, they reviewed a registry of 48,499 patients’ dosages of neuromuscular blocking agents, reversal agents, and other risk factors and determined that NMBs are associated with increased risk of postoperative respiratory complications. Further analysis demonstrated that use of neostigmine as guided by neuromuscular transmission monitoring mitigated that risk.
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April 27th, 2015
Dr. Jennifer Macpherson was co-leader of the workshop, “Lung Isolation Using Bronchial Blockers” at the 4th Annual Thoracic Anesthesia Symposium at the annual meeting of the Society of Cardiovascular Anesthesiologists held in Washington, DC April 11-15. The SCA, an international organization of physicians, promotes excellence in patient care through education and research in perioperative care for patients undergoing cardiothoracic and vascular procedures.
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April 20th, 2015
Drs. Jennifer Gewandter, Robert Dworkin, and co-authors have published an article in PAIN that describes research design considerations for clinical trials of chronic pain prevention. The article has been chosen for publication as an editor’s choice. This article communicates recommendations from an IMMPACT (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials) meeting of pain research experts from around the world. The article covers general design considerations for prevention trials in populations that are at relatively high risk for developing chronic pain. Specific design considerations include subject identification, timing and duration of treatment, outcomes, timing of assessment, and adjusting for risk factors in the analyses. Detailed examinations of 4 models of chronic pain prevention (i.e. chronic post-surgical pain, postherpetic neuralgia, chronic low back pain, and painful chemotherapy-induced peripheral neuropathy) are provided and these discussions, in many cases, can be extrapolated to other chronic pain conditions.
Gewandter JS, Dworkin RH, Turk DC, Farar JT, Fillingim RB, Gilron I, Markman JD, Oaklander AL, Polydefkis MJ, Raja SN, Robinson JP, Woolf CJ, Ziegler D, Ashburn MA, Burke LB, Cowan P, George SZ, Goli V, Graff OX, Iyengar S, Jay GW, Katz J, Kehlet H, Kitt RA, Kopecky EA, Malamut R, McDermott MP, Palmer P, Rappaport BA, Rauschkolb C, Steigerwald I, Tobias J, Walco GA. Research design considerations for chronic pain prevention clinical trials: IMMPACT recommendations. PAIN. In press.
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April 15th, 2015
Drs. Keith Nehrke (Nephrology, not shown) and Paul Brookes (Anesthesiology) have been awarded a $2.5 million grant from the National Heart, Lung, and Blood Institute (NHLBI) to study a new way to prevent the damage caused by a heart attack. The four-year grant collaboration focuses on the harm that results from a lack of blood flow to our body’s most vital organ. Without blood to deliver oxygen, heart cells die or don’t function as well as they should.
Coronary heart disease, which includes chest pain and heart attack, is the number one cause of death for both men and women in the U.S., according to the NHLBI. Currently, other than “plumbing” solutions such as clot-busting drugs, there are no FDA approved drug therapies that physicians can administer before, during or after a heart attack to reduce injury. The team says that the work is a long way from being applied in patients and acknowledges the challenge of delivering a therapy before a heart attack, since you can’t predict when one will strike. But, they say this early research is essential to identifying new treatment strategies and drug targets for major killers like heart disease. “You have to understand the underlying mechanisms of the entire disease process before identifying a drug that can modify the process,” noted Nehrke. “Basic research is like learning to build a car, and clinical research is like taking the car to the track to see how fast it is. Without basic research, you have nothing to test.” This is Nehrke and Brookes’ second collaborative, multiple-principal-investigator NIH grant.
See the full story in the URMC Newsroom, April 6, 2015. /news/story/index.cfm?id=4293
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March 27th, 2015
Drs. Mark Williams, Shannon Smith and Robert Dworkin's abstract, Examining Adverse Event Reporting in Clinical Trials of Interventional Pain Treatments: An ACTTION Systematic Review, has been selected for the distinction of Best of Category for the Patient Safety category from over 750 abstract submissions to the International Anesthesia Research Society (IARS) 2015 Annual Meeting and international Science Symposium, March 21-24, 2015 in Honolulu, HI. At the Annual Meeting, their poster board will receive a Best of Category award ribbon to indicate its prestige as the best abstract submission in the category.
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March 26th, 2015
Dr. Peter Papadakos gave a talk at the annual meeting of the American College of Cardiology in San Diego Ca March 14-15th, titled: "Every Cardiologist Should Not be Active on Social Media" and also participated on a panel "Use of Social Media in CV Diseases: Future of Cardiovascular Medicine. The American College of Cardiology meeting is the largest gathering of cardiologists in the world with a membership of over 49,000.
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March 18th, 2015
Dr. Peter Papadakos and Donna Ford, RN from the Mayo Clinic presented a plenary session entitled, "Driven to Distraction: Managing the Explosion of Personal Devices" at the AORN international meeting in Denver, Colorado on March 8th. The talk centered on patient safety in the OR and professionalism of physicians and nurses. The lecture was also recorded and broadcast several times over the course of meeting. The AORN is the largest professional organizations for nurses working in the OR. Dr. PJ has worked closely with them to develop national guidelines to promote patient safety and professional behavior in the OR.
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March 17th, 2015
Dr. Peter Papadakos and Dr. Marcin Karcz article, “Noninvasive mechanical ventilation in pre and intraoperative and difficult airway”, was published in the Spanish Journal of Anesthesiology and Resuscitation. Dr. Papadakos also published a commentary on social media and electronic distraction in the Chinese journal, “Translational Perioperative and Pain Medicine”.
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March 13th, 2015
Dr. Peter Papadakos was Visiting Professor of Anesthesiology at the University of Colorado at Denver Anschutz Medical Campus on March 9th. He presented Anesthesiology Grand Rounds entitled “Distracted Doctoring: Major Health Care Concern” and a research seminar, “Ventilation Induced Surfactant Dysfunction Role of Ventilation”. He also toured the department and interacted with residents in the OR and ICU.
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March 12th, 2015
Dr. John Schroeder has been named an American Board of Anesthesiology Part 2 (oral boards) Examiner. Typically, 5-10% of nominated diplomates are invited to serve as a Part 2 examiner.
Congratulations, Dr. Schroeder!
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March 4th, 2015
Drs. Laurent Glance, Michael Eaton, Stewart Lustik and colleagues have published the article “The Impact of Anesthesiologists on Coronary Artery Bypass Graft Surgery Outcomes” in the March 2015 issue of Anesthesia & Analgesia. The article also had 5 accompanying editorials. Background: One of every 150 hospitalized patients experiences a lethal adverse event; nearly half of these events involves surgical patients. Although variations in surgeon performance and quality have been reported in the literature, less is known about the influence of anesthesiologists on outcomes after major surgery. The goal of this study was to determine whether there is significant variation in outcomes between anesthesiologists after controlling for patient case mix and hospital quality. Methods: Using clinical data from the NYS Cardiac Surgery Reporting System, the authors conducted a retrospective observational study of 7920 patients undergoing isolated coronary artery bypass graft surgery. Multivariable logistic regression modeling was used to examine the variation in death or major complications (Q-wave myocardial infarction, renal failure, stroke) across anesthesiologists, controlling for patient demographics, severity of disease, comorbidities, and hospital quality. Results: Anesthesiologist performance was quantified using fixed-effects modeling. The variability across anesthesiologists was highly significant (P<0.001). Patients managed by low-performance anesthesiologists (corresponding to the 25th percentile of the distribution of anesthesiologist risk-adjusted outcomes) experienced nearly twice the rate of death or serious complications (adjusted rate 3.33%; 95% confidence interval [CI], 3.09%-3.58%) as patients managed by high-performance anesthesiologists (corresponding to the 75th percentile) (adjusted rate 1.82%; 95% CI, 1.58%-2.10%). This performance gap was observed across all patient risk groups. Conclusions: The rate of death or major complications among patients undergoing coronary artery bypass graft surgery varies markedly across anesthesiologists. These findings suggest that there may be opportunities to improve perioperative management to improve outcomes among high-risk surgical patients. AnesAnalg.2015;3(120);526-533.
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February 16th, 2015
Dr. Marcin Karcz and Dr. Peter Papadakos have published the article, “Noninvasive ventilation in trauma” in the Feb. 4th issue of the World Journal of Critical Care Medicine. Trauma patients are a diverse population with heterogeneous needs for ventilator support. This requirement depends mainly on the severity of their ventilator dysfunction, degree of deterioration in gaseous exchange, any associated injuries, and the individual feasibility of potentially using a noninvasive ventilation approach. Noninvasive ventilation may reduce the need to intubate patients with trauma-related hypoxemia. It is well-known that these patients are at increased risk to develop hypoxemic respiratory failure which may or may not be associated with hypercapnia. Hypoxemia in these patients is due to ventilation perfusion mismatching and right to left shunt because of lung contusion, atelectasis, an inability to clear secretions as well as pneumothorax and/or hemothorax, all of which are common in trauma patients. Noninvasive ventilation has been tried in these patients in order to avoid the complications related to endotracheal intubation, mainly ventilator-associated pneumonia. The potential usefulness of noninvasive ventilation in the ventilator management of trauma patients, though reported in various studies, has not been sufficiently investigated on a large scale. According to the British Thoracic Society guidelines, the indications and efficacy of noninvasive ventilation treatment in respiratory distress induced by trauma have thus far been inconsistent and merely received a low grade recommendation. In this review paper, the authors analyze and compare the results of various studies in which noninvasive ventilation was applied and discuss the role and efficacy of this ventilator modality in trauma.
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February 11th, 2015
Dr. Peter Papadakos was quoted in “The Bulletin” and “NewScientist” on electronic distraction in the OR. In the Feb. 2nd issue of The Bulletin, an article titled, “Cellphones in operating room pose patient safety risks”, discusses distractions from cellphones during surgery and other high-risk medical procedures. The NewScientist article (Feb. 4) is titled “Doc-watcher spots when physicians stop listening”. He also authored an Editorial in “Translational Perioperative and Pain Medicine” on the “Proper Use of Social Networks to benefit Patient Care”.
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February 10th, 2015
Dr. Marcin Karcz won 2nd prize for his podium presentation at the Mount Sinai 33rd Annual International Symposium: Clinical Update in Anesthesiology, Surgery and Perioperative Medicine, titled “Multidisciplinary Approach to an Awake Craniotomy in a Pregnant Patient with a Large Intracranial Mass.” He was mentored and coached by Dr. Peter Papadakos and Dr. Zana Borovcanin. Over 190 people from 16 countries participated in the symposium.
Congratulations, Dr. Karcz!
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February 5th, 2015
Congratulations to Dr. Suzanne Karan who was just approved for a one year academic leave to Israel starting August 2015. Dr. Karan’s yearlong sabbatical in Jerusalem will be used to conduct research at Hadassah Medical Center. The focus of this research will be obstructive sleep apnea during pregnancy and its impact on intrauterine growth retardation. Dr. Karan is fortunate to be collaborating with investigators at the U of R – Dr. Jacob Nadler, and also Dr. Lynn Liu (Neurology) & Dr. Loralei Thornburg (OBGyn) who will likely be initiating parallel studies in Rochester that would be continued on Dr. Karan’s return in August 2016.
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February 2nd, 2015
Dr. Laurent Glance has co-authored a paper published in the February 2015 issue of Anesthesia & Analgesia titled, “What can the national quality forum tell us about performance measurement in anesthesiology?”
Hyder JA, Niconchuk J, Glance LG, Neuman MD, Cima RR, Dutton RP, Nguyen LL, Fleisher LA, Bader AM. What can the national quality forum tell us about performance measurement in anesthesiology? Anesth Analg. 2015 Feb,120(2):440-8. Doi:10.1213/ANE.0000000000000553. PMID:25602454
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January 30th, 2015
Drs. Jacek Wojtczak and Sonia Pyne have published the article, “Teaching Ultrasound Procedural Skills - Low Cost Phantoms and Animal Models”, in the October 2014 issue of the Middle East Journal of Anesthesiology. Acquiring the necessary cognitive and psychomotor skills to perform ultrasound guided procedures may require initial training. Growing evidence shows that simulation can help in the acquisition of procedural skills. Commercially available phantoms are expensive, have non-tissue like haptics, are preformed with fixed targets and do not allow for additional targets to be imbedded. In this study, the authors described several new phantoms and animal models that are inexpensive, easy to assemble and allow a rapid change of targets. Such phantoms can provide an ideal initial learning opportunity in a zero-risk environment.
January 29th, 2015
Dr. Kenessa Edwards, CA-3 resident, and Cheryl Johnson, CRNA, recently volunteered at the Young Women’s College Prep Charter School Career Day, Rochester’s first all-girl’s public school. The purpose of the career day was to feature women from diverse personal and professional backgrounds to excite 7th-9th grade girls about future career opportunities. Dr. Edwards and Cheryl spoke to small groups of students about a career in Anesthesiology and the steps they took to get there, including education, skills needed to be successful, daily responsibilities, and challenges. The teens enjoyed hearing about Anesthesiology and many were interested in going into medicine. Dr. Edwards and Cheryl were unanimous in saying this was a wonderful volunteer experience.
January 28th, 2015
Dr. Jacek Wojtczak has received recognition as a Distinguished Fellow of the Kosciuszko Foundation Collegium of Eminent Scientists for outstanding achievements and contributions to the Polish scientific community. Founded in 1925, The Kosciuszko Foundation promotes closer ties between Poland and the United States through educational, scientific and cultural exchanges. The list of scholars includes four Nobel Prize winners, 22 members (foreign) of the Polish Academy of Sciences, several members of the U.S. Academy of Sciences, and other renowned scientists.
January 27th, 2015
Dr. Robert Dworkin is the 2015 recipient of the Mitchell B. Max Award for Neuropathic Pain, given in recognition of his outstanding achievements and work in the field of neuropathic pain. Dr. Dworkin is the first non-neurologist to receive the award, which is sponsored by the American Academy of Neurology, and will be presented at their annual meeting in April.
Congratulations, Dr. Dworkin!
January 23rd, 2015
In the February 2015 issue of OR Manager, Dr. Peter Papadakos is quoted in the Human resources article, “Wise use of social media can enhance your professional career”. The quotes came from an article Dr. Papadakos published in the Journal of Anesthesiology Clinical Research.
January 22nd, 2015
Dr. Peter Papadakos was quoted extensively in an article in the Periop Insider, the weekly newsletter of the Association of periOperative Registered Nurses, titled “Mobile Tech in the OR: Are Your Policies Strong Enough?”. Dr. PJ will also be speaking this March at AORN’s Surgical Conference & Expo (March 7-11 in Denver) to share strategies for preventing mobile device distraction in the perioperative setting.
January 21st, 2015
Dr. Laurent Glance will be the visiting professor at Vanderbilt University on Thursday and Friday, Jan. 22-23, 2015. He will be giving two talks: Health care reform and the Anesthesiologist and Blood Transfusion: Evidence-based or Faith-based.
January 21st, 2015
Dr. Laurent Glance will deliver the FAER-Helrich Research Lecture at the 2015 annual meeting of the ASA in San Diego on Monday, Oct. 26, 2015, one of the keynote lectures for the meeting. The FAER-Helrich Research Lecture recognizes outstanding scholarship by a scientist in an effort to encourage young anesthesiologists to consider careers in research and teaching, which are crucial if Anesthesiology is to maintain its reputation as a medical specialty continuously striving for excellence in patient care.
January 15th, 2015
Dr. PJ Papadakos served as the Thomas Iberti Memorial Visiting Professor of Surgery at the Mount Sinai School of Medicine January 14-15. Dr. Papadakos presented Grand Rounds in Surgery entitled, "Surfactant Dysfunction in Mechanical Ventilation", and also participated in teaching rounds in the surgical ICU and interacted with medical students, residents in surgery and anesthesiology, fellows and faculty. The annual lectureship honors Dr. Thomas Iberti the Director of Critical Care medicine at Mount Sinai from 1983-1993 who was one of the pioneers of the field of Critical Care. Previous honorees have been internationally known experts in Critical Care, and Dr. PJ was humbled to join their ranks.
January 12th, 2015
Dr. Peter Papadakos, has a commentary featured in the January 2015 issue of Anesthesiology News, titled “EMRs and Smart Technology: Vectors of Infection in a Modern World”, which discusses the spread of infections via the touch screens on personal electronic devices.
January 5th, 2015
Dr. Peter Papadakos, along with his physician assistant colleagues, Mr. LaRiccia and Ms. Carpenter, published a paper in the January issue of Journal American Academy of Physician Assistants (JAAPA) dealing with malignant hyperthermia. JAAPA is the major journal of that profession.
Carpenter V, LaRiccia B, Papadakos PJ. Malignant Hyperthermia in a Trauma Patient. JAAPA 2015; 28(1):45-47, PMID 25522026
December 31st, 2014
Drs. Jennifer Gewandter and Shannon Smith, along with Drs. Robert Dworkin, Kenessa Edwards (not shown), Joseph Pawlowski, and Daniel Rothstein (respectively) evaluated reporting practices in peer-reviewed publications of pain related to temporomandibular disorders. Specification of primary outcome analyses, methods to accommodate missing data, and adverse event collection methods and rates were generally poor. This review alerts authors, reviewers, and editors involved in the publication of TMD trials to these reporting issues with the goal of improving reporting quality in the future.
Gewandter JS, Smith SM, McKeown A, Edwards K, Narula A, Pawlowski J, Rothstein D, Desjardins PJ, Dworkin SF, Gross RA, Ohrbach R, Rappaport BA, Sessie BJ, Turk DC, Dworkin RH. Reporting of adverse events and statistical details of efficacy estimates in randomized clinical trials of pain in temporomandibular disorders: ACTTION systematic review.
December 29th, 2014
Dr. Jacek Wojtczak has published two articles in the Journal of Ultrasonography, both in Issue 14, pp 362-366 and 367-370, respectively. The first is titled “Laryngo-tracheal ultrasonography to confirm correct endotracheal tube and laryngeal mask airway placement”. Waveform capnography was recommended as the most reliable method to confirm correct endotracheal tube or laryngeal mask airway placements. However, capnography may be unreliable during cardiopulmonary resuscitation and during low flow states. It may lead to an unnecessary removal of a well-placed endotracheal tube, re-intubation and interruption of chest compressions. Real-time upper airway (laryngo-tracheal) ultrasonography to confirm correct endotracheal tube placement was shown to be very useful in cadaveric models and during emergency intubation. Tracheal ultrasonography does not interrupt chest compressions and is not affected by low pulmonary flow or airway obstruction, but is limited by ultrasonography scattering and acoustic artifacts generated in air – mucosa interfaces. Sonographic upper airway assessment emerges as a rapid and easily available method to predict difficult intubation, to assess the laryngeal and hypopharyngeal size and visualize the position of the laryngeal mask airway in situ. This study demonstrates that the replacement of air with saline in endotracheal tube or laryngeal mask airway cuffs and the use of the contrast agents enables detection of cuffs in the airway. It also allows visualization of the surrounding structures or tissues as the ultrasound beam can be transmitted through the fluid-filled cuffs without being reflected from air–mucosal interfaces.
The second article is titled, “Models to teach lung sonopathology and ultrasound-guided thoracentesis”. Lung sonography allows rapid diagnosis of lung emergencies such as pulmonary edema, hemothorax or pneumothorax. The ability to timely diagnose an intraoperative pneumothorax is an important skill for the anesthesiologist. However, lung ultrasound exams require an interpretation of not only real images but also complex acoustic artifacts such as A-lines and B-lines. Therefore, appropriate training to gain proficiency is important. Simulated environment using ultrasound phantom models allows controlled, supervised learning, have developed hybrid models that combine dry or wet polyurethane foams, porcine rib cages and human hand simulating a rib cage. These models simulate fairly accurately pulmonary sonopathology and allow supervised teaching of lung sonography with the immediate feedback. In-vitro models can also facilitate learning of procedural skills, improving transducer and needle positioning and movement, rapid recognition of thoracic anatomy and hard-eye coordination skills. We described a new model to teach an ultrasound guided thoracentesis. This model consists of the experimenter’s hand placed on top of the water-filled container with wet foam. Metacarpal bones of the human hand simulate a rib cage and a wet foam simulates a diseased lung immersed in the pleural fluid. Positive fluid flow offers users feedback when a simulated pleural effusion is accurately assessed.
December 17th, 2014
Congratulations to Cardiothoracic Anesthesia Fellow Dr. Tracy Sisk (left) and Dr. Janine Shapiro (right) for winning first prize at the Scientific Panel 16th Annual Bragging Contest: Any Case You have Done, I have Done a Better One, Representing University of Rochester School of Medicine and Dentistry at the 68th Annual PostGraduate Assembly in Anesthesiology.
December 17th, 2014
Dr. Peter Papadakos participated at the 60th International Respiratory Convention, the annual meeting of the American Association of Respiratory Care, December 9-12, where he was honored as the outgoing Chair of the Board of Medical Advisors and for his contributions to the profession. He also served on the Board of Directors of the Society for 2013-14. Beginning next year, the annual award for the best student paper at the annual meeting will be named the Papadakos Award. Dr. PJ is honored to aid in the development of future academic leaders of the profession. The American Association of Respiratory Care has approximately 50,000 members worldwide.
December 3rd, 2014
Dr. Jennifer Macpherson will be one of the speakers at the inaugural PGA Thoracic Anesthesia Symposium to be held Dec. 11-12, 2014. The one and-a-half day program will feature leading national and international experts in thoracic anesthesia, and will feature topics such as Prevention of Lung Injury During Thoracic Surgery, Lung Separation and the Difficult Airway, Surgical and Anesthetic Management of Esophagectomy, Discussions of Challenging Cases, PBLDs, Pro/Con Debate, and Thoracic Anesthesia Hands-on Workshop.
December 3rd, 2014
Dr. Peter Papadakos and colleagues have published the article, “Noninvasive mechanical ventilation in high-risk pulmonary infections: a clinical review” in the journal, European Respiratory Review. The aim of the article was to review the role of noninvasive ventilation (NIV) in acute pulmonary infectious diseases, such as severe acute respiratory syndrome (SARS), H1N1 and tuberculosis, and to assess the risk of disease transmission with the use of NIV from patients to healthcare workers.
Antonio M. Esquinas, S. Egbert Pravinkumar, Raffaele Scala, Peter Gay, Arie Soroksky, Christophe Girault, Fang Han, David S. Hui, Peter J. Papadakos, and Nicolino Ambrosino on behalf of the International NIV Network. Noninvasive mechanical ventilation in high-risk pulmonary infections: a clinical review. Eur Respir Rev 2014; 23:427-438 | DOI:10.1183/09059180.00009413
December 2nd, 2014
Dr. Peter Papadakos' article, “The Day Medicine Stood Still” was featured on the cover of the November 2014 issue of “Anesthesiology News”.
November 21st, 2014
Drs. Anna Kaminski (Left), Michael Eaton (Center), Peter Knight, David Stern (Right), and Andrew Sifain have published in the Echo Rounds section of the December issue of Anesthesia & Analgesia. The article is titled, “Mitral Valve Repair Failure Diagnosed with a Sudden Change in Jet Direction from Posterior to Anterior: Inconsistent with Systolic Anterior Motion”.
Anesthesia & Analgesia, Dec 2014;119(6), pp 1271-1274
Drs. Gewandter, Pawlowski, Poli, Rothstein, Dworkin & Smith Publish in Journal of Pain
November 21st, 2014
Drs. Jennifer Gewandter, Joseph Pawlowski, Joseph Poli (not shown), Daniel Rothstein, Robert Dworkin, and Shannon Smith (Respectively) have published an article that reviews the completeness of sample size calculation reporting in recent analgesic clinical trials. This article discusses the importance of reporting all elements of sample size calculations, given the ethical implications of underpowered or overpowered clinical trials.
McKeown A, Gewandter JS, McDermott MP, Pawlowski JR, Poli JJ, Rothstein D, Farrar JT, Gilron I, Katz NP, Lin AH, Rappaport BA, Rowbotham MC, Turk DC, Dworkin RH, Smith SM. Reporting of sample size calculations in analgesic clinical trials: ACTTION systematic review. Journal of Pain, in press.
Drs. Gewandter, Smith, Williams & Dworkin Publish in Pain
November 19th, 2014
Drs. Jennifer Gewandter, Shannon Smith, Mark Williams, and Robert Dworkin (Respectively) have published an article describing “spin” or misrepresentation of statistically non-significant results in analgesic clinical trials in the Journal of Pain.
Jennifer S. Gewandter, Michael P. McDermott, Andrew McKeown, Shannon M. Smith, Robert A. Gross, Matthew Hunsinger, Allison H. Lin, Bob A. Rappaport, Andrew S.C. Rice, Michael C. Rowbotham, Mark R. Williams, Dennis C. Turk, Robert H. Dworkin. Data interpretation in analgesic clinical trials with statistically non-significant primary analyses: An ACTTION systematic review. Journal of Pain. In press.
Mary Therese Biltucci Publishes in Clinical Implant Dentistry and Related Research
November 19th, 2014
Mary Therese Biltucci, MA and co-authors have published the article, “Bacterial Composition at the Implant-Abutment Connection under Loading in vivo”, in the journal, Clinical Implant Dentistry and Related Research.
Purpose: Platform-switched implants have been demonstrated to prevent bone loss after loading. The present study evaluated bacterial composition of sites from implant-abutment connections of immediately loaded implants, which were placed in the anterior mandible. Ten patients participated in this study.
Conclusions: Chlorhexidine irrigation does not seem to have any effect on decontamination of connections. As shown previously, there is significantly more bone loss around B implants compared with A implants. Although there was no statistical difference in the microbial profiles, thee was indeed a trend for the presence of typical periodontal pathogens associated with the internal polygonal butt-joint connection. A possible scenario is that this connection tends to harbor the pathogens that may be involved in subsequent bone loss.
Georgios E. Romanos, DDS, PhD, Prof. Dr. med. Dent.; Mary Therese Biltucci, MA; Alexis Kokaras, PhD; Bruce J. Paster, PhD. Bacterial Composition at the Implant-Abutment Connection under Loading in vivo. Clin Implant Dentistry and Related Res, 2014.
PACE – Dec 4th, 2014
November 7th, 2014
Please join us for this informative session on Physicians & Attorneys Cooperative Education on December 4th, 2014
Dept. of Anesthesiology
University of Rochester Medical Ctr.
For more information please go to the PACE Event Page.
Dr. Jacek Wojtczak Publishes in Journal of Anesthesiology & Clinical Science
October 30th, 2014
Dr. Jacek Wojtczak, together with Dr. Davide Cattano and his group, have published the article, “External neck landmark identification and measurement correlation in a normal weight cohort” in Volume 3, Article 7 of the Journal of Anesthesiology & Clinical Science.
Abstract:
Background: Airway management, including proper airway devices sizing, is dependent on airway features, which ultimately should correlate with body features: unfortunately such correlation has been inconsistent. The aim of this study was to determine the correlation of normal values of several external neck landmark (airway features) measurements with age, gender, height and weight (body features) for normal weight adult subjects to establish a consistent correlation.
Methods: After IRB approval, 200 subjects (100 male and 100 female) were enrolled. External neck landmarks were measured using a measuring tape. Measurements were also assessed by digital caliper to compare marginal errors. Only non-obese (BMI <30 kg/m2) adults presenting for preoperative anesthesia assessment were screened.
Results: A total of 200 subjects completed the study. The difference between female and male hyocricoid distance (6.0+1.3 cm and 6.5+1.4 cm; P<0.01) and thyroid width (4.9+0.8 cm and 5.3+ 0.7 cm; P<0.001) was statistically significant. Univariate regression analysis demonstrated ENLs measurements were correlated with different physical characteristics except the occipital distance which did not provide any correlation with the airway anatomical variables.
Conclusion: There was a significant correlation between: thyromental, hyoidcricoid and thyroid width distances with height and weight (P<0.0001); thyroid height and throcricoid distances with height (P=0.027 and P=0.008, respectively); hyoidmental with age (P=0.037), and sternomental distance with height and age (P<0.0001). Results from multivariate regression provided interesting insight into the association between each ENL, airway features and physical characteristics. These findings may be useful to determine prediction models of important neck landmarks measurements when actual measurements are not feasible.
Dr. Zana Borovcanin Recipient of 2014 MCIC “Risk Reduction Awards Program” Grant
October 23rd, 2014
Dr. Zana Borovcanin has been awarded a $50,000 grant from the MCIC Risk Reduction Awards Program. MCIC Vermont, Inc. is the medical malpractice carrier for the University of Rochester Medical Center. Part of the MCIC mission is to prevent harm that leads to litigation. As a part of the MCIC 2014 strategic plan, funding is available for projects that propose innovative ways in reducing risk. Dr. Borovcanin’s project, “Implementation and Evaluation of URMC Difficult Airway Response Team (DART)”, will help establish a DART team at URMC, which will be capable of delivering the highest-quality and safest care during difficult airway management at our institution.
Congratulations to Dr. Borovcanin and co-investigators: Janine Shapiro, MD, Sarah Peyre, EdD, Oren Harary, MBA, MPH, and Changyong Feng, PhD
Residency Program 1st Place in Lifebox Challenge!
October 16th, 2014
Announced in October, 2013, the first Annual Resident Lifebox Challenge is an initiative of the ASA Resident Component to engage U.S. anesthesiology residents in support of the global safe surgery program of the Lifebox Foundation. ASA's Charitable Foundation serves as the platform for the resident fundraising activities.
At the 2014 ASA annual meeting in New Orleans, it was announced that the University of Rochester Residency Program swept the competition (11 other academic programs participated) in both total contributions and per resident giving! In addition, by raising the largest absolute dollar contribution, our program is eligible for a matching gift to increase our gift to Lifebox.
Congratulations and thanks to all who donated!
Drs. Gewandter, Smith, Pawlowski, Poli, Rothstein, Williams & Dworkin Publish Article in Pain
October 2nd, 2014
Dr. Jennifer Gewandter (right), and co-authors, including Anesthesiology residents, Drs. Joseph Pawlowski, Daniel Rothstein, and Mark Williams, former resident, Dr. Joseph Poli, Dr. Shannon Smith, and Dr. Robert Dworkin published an article describing the reporting of intention-to-treat analyses in analgesic clinical trials. The study found that the phrase “intention-to-treat” is frequently used to describe analyses that exclude randomized participants. Recommendations to use the term “intention-to-treat” consistently to facilitate interpretation of RCTs are provided.
Jennifer S. Gewandter, Michael P. McDermott, Andrew McKeown, Shannon M. Smith, Joseph R. Pawlowski, Joseph J. Poli, Daniel Rothstein, Mark R. Williams, Shay Bujanover, John T. Farrar, Ian Gilron, Nathaniel P. Katz, Michael C. Rowbotham, Dennis C. Turk, Robert H. Dworkin. Reporting of intention-to-treat analyses in recent analgesic clinical trials: ACTTION systematic review and recommendations. Pain. In press.
Dr. Daryl Smith Publishes in Case Reports in Emergency Medicine
September 29th, 2014
Dr. Daryl Smith has published an article in Vol. 2014 of Case Reports in Emergency Medicine, titled “Treatment of Acute Flares of Chronic Pancreatitis Pain with Ultrasound Guided Transversus Abdominis Plane Block: A Novel Application of a Pain Management Technique in the Acute Care Setting”. Doi:10.1155/2014/759508
Drs. Daryl Smith, Sarah Kralovic, and Garret Morris Article Accepted to ASAIO Journal
September 19th, 2014
Drs. Daryl Smith, Sarah Kralovic, Garret Morris (left) and colleagues have had their paper accepted for publication in the ASAIO Journal. Their article is titled, “Trial Ultrasound Guided Continuous Left Stellate Ganglion Blockade Prior to Surgical Gangliolysis in a Patient with a Left Ventricular Assist Device and Intractable Ventricular Tachycardia: A Pain Control Application to a Complex Hemodynamic Condition”.
Drs. Glance and Wissler's Article Featured in Several News Outlets, Including an Interview with NPR
September 11, 2014
Drs. Laurent Glance and Richard Wissler's article in Health Affairs on obstetrical outcomes has been featured in several media outlets.
Titled, “Study: Wide hospital quality gap on maternity care”, it was featured with the Associated Press, ABC News, FoxNews, HealthDay, Intelihealth, KWTX, Medbroadcast, Medscape, North Dallas Gazette, San Francisco Chronicle, US News & World Report, Washington Post, Health Affairs blog, WBUR Boston, and Fosters Daily Democrat.
Dr. Glance was also interviewed by NPR.
Link to the interview
Residents, Drs. Pereira and Williams Publish in Pain
September 2, 14
Dr. Anthony Pereira first-authored a literature review on the implications for chronic pain treatment of antidepressant-associated suicidal ideation and behavior that has just been accepted for publication by Pain. Dr. Mark Williams served as co-author of a literature review on acute and chronic pain associated with Lyme borreliosis that was just published in Pain. References to both of these articles appear below:
Zimering JH, Williams MR, Eiras ME, Fallon BA, Logigian EL, Dworkin RH. Acute and chronic pain associated with Lyme borreliosis: clinical characteristics and pathophysiologic mechanisms. Pain, 2014;155:1435-1438.
Pereira A, Conwell Y, Gitlin MJ, Dworkin RH. Suicidal ideation and behavior associated with antidepressant medications: implications for the treatment of chronic pain. Pain, in press.
Dr. Papadakos Grand Rounds Speaker at Drexel School of Medicine
August 14, 2014
Dr. Peter Papadakos was the Visiting Professor at the Drexel School of Medicine’s Hahnemann University Hospital in Philadelphia on July 29th. His Perioperative Medicine Grand Rounds presentation for the Departments of Anesthesiology, Surgery and Nursing was titled, “Distracted Doctoring a Major Health Care Safety Concern”.
Dr. Papadakos Letter to Editor in Chest
August 11, 2014
Dr. Peter Papadakos published a commentary in the August issue of Chest, the journal of the American College of Chest Physicians. In his role as Chairman of the Board of Medical Advisors which provides oversight to the American Association of Respiratory Therapists, Dr. Papadakos’ letter is in support of legislation HR 2619 before Congress to allow respiratory therapists to practice independently under the supervision of a physician to aid in the care of patients with complex respiratory diseases. This collaboration would greatly aid in the predicted shortage of pulmonary physicians and hopefully impact on the rate of readmissions to hospitals and thus impact on health care costs.
Papadakos PJ. Board of Medical Advisors Supports HR 2619. Chest. 2014;146(2):e61-e62.
Link to Article
Drs. Glance, Wissler, and Marroquin Publish Paper in Health Affairs
August 7, 2014
Drs. Laurent Glance, Richard Wissler, Bridget Marroquin, and colleagues Drs. Dick, Glantz, Qian, Mukamel and Kellermann have published the paper, “Rates of Major Obstetrical Complications Vary Almost Fivefold Among US Hospitals”, in Health Affairs (Health Aff [Millwood]. 2014 Aug 1;33(8):1330-6. doi: 10.1377/hlthaff.2013.1359.)
Author information
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Laurent G. Glance is vice chair for research and a professor of anesthesiology and public health sciences at the School of Medicine and Dentistry, University of Rochester, in New York.
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Andrew W. Dick is a senior economist at the RAND Corporation in Boston, Massachusetts.
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J. Christopher Glantz is a professor of obstetrics and gynecology at the School of Medicine and Dentistry, University of Rochester.
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Richard N. Wissler is a professor of anesthesiology at the School of Medicine and Dentistry, University of Rochester.
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Feng Qian is an assistant professor of health policy and management, School of Public Health, University at Albany, in New York.
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Bridget M. Marroquin is an assistant professor of anesthesiology at the School of Medicine and Dentistry, University of Rochester.
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Dana B. Mukamel is a professor in the Department of Medicine, University of California, Irvine.
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Arthur L. Kellermann is a professor in and dean of the F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, in Bethesda, Maryland.
Abstract
Of the approximately four million women who give birth each year in the United States, nearly 13 percent experience one or more major complications. But the extent to which the rates of major obstetrical complications vary across hospitals in the United States is unknown. We used multivariable logistic regression models to examine the variation in obstetrical complication outcomes across US hospitals among a large, nationally representative sample of more than 750,000 obstetrical deliveries in 2010. We found that 22.55 percent of patients delivering vaginally at low-performing hospitals experienced major complications, compared to 10.42 percent of similar patients delivering vaginally at high-performing hospitals. Hospitals were classified as having low, average, or high performance based on a calculation of the relative risk that a patient would experience a major complication. Patients undergoing a cesarean delivery at low-performing hospitals had nearly five times the rate of major complications that patients undergoing a cesarean delivery at high-performing hospitals had (20.93 percent compared to 4.37 percent). Our finding that the rate of major obstetrical complications varies markedly across US hospitals should prompt clinicians and policy makers to develop comprehensive quality metrics for obstetrical care and focus on improving obstetrical outcomes.
Project HOPE—The People-to-People Health Foundation, Inc.
URMC Newsroom Article
Dr. Papadakos Publishes in Respiratory Care
July 30, 2014
Dr. Peter Papadakos’ article titled, “Electronic Distractions of the Respiratory Therapist and Their Impact on Patient Safety”, was published in the August 2014 issue of Respiratory Care. [Respir Care 2014;59(8):1306-1309]
Dr. Papadakos’ Article on URMC Select Major News Coverage
July 10, 2014
Dr. Peter Papadakos, who was quoted in the NY Times article Google Glass Enters the Operating Room, has also been featured in URMC Select Major News Coverage.
"The display can also be used to see email and surf the web, potentially allowing doctors to take multitasking to dangerous new levels, said Peter J. Papadakos at the University of Rochester Medical Center, who has published articles on electronic distractions in medicine."
URMC Select Major News Coverage
Dr. Lerman honored at "Sixth Salute to UB Authors"
July 2, 2014
Jerrold Lerman, MD, Chief of Clinical Research & Professor of Anesthesiology, University at Buffalo and Women & Children’s Hospital of Buffalo, was recognized by the University at Buffalo on May 5, 2014 at “An Anthology of Recognition: The Sixth Salute to UB Authors.”
The event, which honors UB authors who have published full-length scholarly books over the course of the past two years — from January 2012 through December 2013, paid tribute to more than 105 authors, contributing authors and editors.
Dr. Lerman was honored for the 5th Edition of his new textbook, “A Practice of Anesthesia for Infants and Children,” which provides complete coverage of the safe, effective administration of general and regional anesthesia to infants and children - covering standard techniques as well as the very latest advances.
Dr. Lerman has authored three textbooks with the third coming out later this year.
Congratulations, Dr. Lerman!
Click to read this article on kaleidahealth.
Dr. David Stern Mentioned in The Wall Street Journal
July 2, 2014
Excerpt: 'He points to David Stern, who is 63. Dr. Stern, an associate professor of anesthesiology at the University of Rochester Medical Center, took up the violin at age 55 when he began playing with the Rochester New Horizons orchestra. When he started, Dr. Stern recalls, he produced a sound "that the cat hated worse than the vacuum cleaner." But the same nimble fingers that allowed him to insert catheters into patients served him well on the violin.' Read the full article from The Wall Street Journal
Dr. Jennifer Gewandter First Author on Article Pubished in PAIN
June 25, 2014
Dr. Jennifer Gewandter and co-authors published a systematic review that identified deficiencies in reporting of missing data and methods to accommodate them in analgesic clinical trials. The article provides a review of methods to accommodate missing data that are recommended by statisticians and regulators, and provides recommendations for authors, reviewers, and editors pertaining to reporting of these important statistical details.
Jennifer S. Gewandter, Michael P. McDermott, Andrew McKeown, Shannon M. Smith, Mark R. Williams, Matthew Hunsinger, John T. Farrar, Dennis C. Turk, Robert H. Dworkin
Dr. Peter Papadakos Quoted in New York Times Article and Featured on Reporte Indigo
June 4, 2014
Dr. Peter Papadakos was quoted in the Sunday, June 1st, edition of the NY Times. In an article titled, "Google Glass Enters the Operating Room", Dr. Papadakos comments, "Being able to see your laparoscopic images when you're operating face to face instead of looking across the room at a projection screen is just mind-bogglingly fantastic," he said. "But the downside is you don't want that same surgeon interacting with social media while he's operating." To read the entire article, visit the New York Times.
Dr. Papadakos was also featured on Reporte Indigo titled "Tweezers, scalpel, Smartphone?" discussing electronic distration in the operating room:
(Translated from Spanish)
A survey of perfusionists revealed 55 percent used their cell phone during cardiac surgery.
Currently, some of the medical negligence is due to “distracted doctoring”, a phenomenon in which doctors do not release their mobile devices, even in the operating room. Campaigns exist that talk about the risks of driving and texting at the same time . There is also talk of distraction between parents and children who are absorbed in the screens of their mobile devices. But not enough attention is paid to another scenario where the use of mobile devices can compromise the health and endanger the lives of others: the operating room.
To read the entire article, visit Reporte Indigo.
Dr. Jennifer Gewandter Pubishes Article in PAIN
May 27,2014
Dr. Jennifer Gewandter and co-authors published an article describing research design considerations for proof-of-concept (POC) chronic pain clinical trials, addressing both exploratory and preliminary efficacy objectives. General considerations regarding POC trials, as well as major POC trial designs and their advantages and limitations are discussed. Designs that maximize statistical power by decreasing variability in outcomes, maximizing effect size, or minimizing participant withdrawal are reviewed. This article communicates consensus recommendations from an IMMPACT (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials) meeting of pain research experts from around the world.
Jennifer S. Gewandter, Robert H. Dworkin, Dennis C. Turk, Michael P. McDermott, Ralf Baron, Marc R. Gastonguay, Ian Gilron, Nathaniel P. Katz, Cyrus Mehta, Srinivasa N. Raja, Stephen Senn, Charles Taylor, Penney Cowan, Paul Desjardins, Rozalina Dimitrova, Raymond Dionne, John T. Farrar, David J. Hewitt, Smriti Iyengar, Gary W. Jayr, Eija Kalso, Robert D. Kerns, Richard Leff, Michael Leong, Karin L. Petersen, Bernard M. Ravina, Christine Rauschkolb, Andrew S. C. Rice, Michael C. Rowbotham, Cristina Sampaio, Søren H. Sindrup, Joseph W. Stauffer, Ilona Steigerwald, Jonathan Stewart, Jeffrey Tobias, Rolf-Detlef Treede, Mark Wallace, Richard E. White. Research designs for proof-of-concept chronic pain clinical trials: IMMPACT recommendations. Pain, In press.
Third Annual Lawrence Educational Symposium: Focus on Sedation
May 12, 2014
The third annual Lawrence Educational Symposium took place on May 8th with over 60 participants! This year’s theme was “Focus on Sedation” and 13 abstracts representing sedation cases and challenges were presented. The panel featured Drs. Michael Nead (Medicine), Joel Pasternack (Emergency Medicine), Rajbala Thakur (Anesthesiology) and Elise Van der Jagt (Pediatrics). The discussion was moderated by Dr. Suzanne Karan. Awards were presented at the end of the evening for:
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Most novel poster presentation: Drs. Bryce Yerman and Henry Tran for “Sedation in a minivan”
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Poster with most academic value: Drs. Williams, Kothari and Karan for “Challenging sedation in a patient with sickle cell disease on chronic opioid therapy
Thank you to Dr. Ruth Lawrence and her family for endowing the funds that allow our department to host this annual event in the memory of her late husband, Dr. Robert Lawrence, who was our department’s first anesthesiology resident.
Difficult Airway Workshop conducted on March 6th and May 3rd
May 8, 2014
The Difficult Airway Workshop, which is organized by Dr. Zana Borovcanin, is designed to provide residents with state-of-the-art information and hands-on experience with a wide range of established and novel airway techniques. This all-day educational activity is divided in two parts: didactic sessions in the morning followed up with hands-on workshop with eight stations in the afternoon. The last two difficult airway workshops covered multiple skill stations which included adult flexible fiberoptic intubation, airway anesthesia for awake intubation, airway exchange catheters, fiberoptic intubation via supraglottic airway using Aintree catheter, video laryngoscopes and fiberoptic stylets. There was a special station for pediatric difficult airway management covering pediatric flexible fiberoptic intubation and video laryngoscopy. Retrograde wire intubation and surgical airway - cricothyrotomy were performed in simulated airway scenarios. A percutaneous cricothyrotomy was practiced in a pig trachea lab, and conducted by Dr. Lyons. The Workshop also focused on use of endobronchial blockers and fiberoptic lung separation in the difficult airway management.
Many aspects of difficult airway management in a variety of clinical settings were highlighted during the Workshop. The goal of the Difficult Airway Workshop is also to learn to appropriately apply the ASA Difficult Airway Algorithm and to develop an understanding of the critical decision points in the course of the difficult airway management.
A special thanks to Drs. Dooley, Gloff, Kaminski, Karan, Kolano, Lyons, Tran, Tzimas, Subrahmanian and Sekhar for their participation and teaching in the last two Difficult Airway Workshops. We are grateful to Cook Medical, Karl Storz Endoscopy and Verathon Medical that provided us with their products and demonstrations.
For the full slide show of the Difficult Airway Workshop photos (March 6th and May 3rd) go to the URMC Department of Anesthesiology Facebook page.
Dr. Gail Johnson Awarded $250,000 Grant
May 8, 2014
Dr. Papadakos Featured in ASA Article
May 8, 2014
In a May 2014 article on the American Society of Anesthesiologists’ web site titled, “Situational Awareness, Multitasking, and Distraction in the O.R.”, Dr. Peter Papadakos was featured. The authors state, “Recently, it was suggested by Dr. Papadakos in Anesthesia and Clinical Research that a modified CAGE questionnaire (traditionally used to assess risk factors for alcohol abuse, Table 1) could be used to identify those with a significant addiction to their personal electronic devices (PED). In effect, it would help identify those at risk of being distracted by their own actions before they entered the O.R.”
Dr. Marcin Karcz Approved for FAER Grant
April 30, 2014
Dr. Marcin Karcz has been approved for a Foundation for Anesthesia Education Research (FAER) Research Fellowship Grant. His application was titled, “The role of antihistamines and nicotine metabolites in cardioprotection.”
Congratulations, Marcin!
Dr. Jacek Wojtczak To Present At Transthoracic Ultrasound Workshop
April 21, 2014
Dr. Jacek Wojtczak will be presenting at transthoracic ultrasound workshops during the Harvard Ultrasound Course for Intensivists and Emergency Medicine Clinicians, being held April 25-27, 2014 at the Carl J. Shapiro Clinical Center at Beth Israel Decsoness Medical Center.
Specifically designed for Critical Care and Emergency Medicine Physicians, the course covers all current application of critical care ultrasound. The course covers basic use of Transthoracic Echocardiography (TTE) in the setting of cardiac arrest/peri-resuscitation, and in the management of the patient in shock. In addition, the course will cover emeging topics in critical care ultrasound, such as lung ultrasound for the diagnosis of pneuomothorax, pulmonary edema and pneumonia, it will review in detail the FAST Protocol, the international standard ultrasound protocol for the management of the patient with trauma.
For additional information, visit www.cme.hms.harvard.edu/courses/echocardiography.
Dr. Papadakos Assists with AORN Policy and Cited in Pacific Standard Magazine
April 21, 2014
Dr. Peter Papadakos, a leader in electronic distraction prevention, helped develop the AORN policy, "AORN Position Statement on Managing Distractions and Noise During Perioperative Patient Care", to deal with electronic distraction in the perioperative environment. The policy was released 4/15/14 and can be found on the AORN webpage.
Dr. Papadakos was also featured in the Pacific Standard: The Science of Society in an article titled, "The Dangerous Rise of Social Media in the Operating Room."
Dr. Glance Publishes Editorial in the New England Journal of Medicine
April 10, 2014
Dr. Laurent Glance has co-authored an editorial titled, "Redesigning Surgical Decision Making for High-Risk Patients", which was published in the April 10th issue of The New England Journal of Medicine.
Glance LG, Osler TM, Neuman MD. Redesigning Surgical Decision Making for High-Risk Patients. N Engl J Med 370:15;1379-1381
Alastair J. Gillies, MD 1924-2014
April 7, 2014
Dr. Alastair J. Gillies, the first Chair of the Department of Anesthesiology, passed away recently at the age of 89.
Dr. Gillies was educated at the University of Edinburgh and trained at the Royal Infirmary in Edinburgh. He served on the medical staff in the RAF during the war. As a physician, he followed in the footsteps of his father, an anesthesiologist for the Royal Family in the UK around WWII. He joined the faculty at the University of Rochester in 1959.
During his tenure as Chair from 1969 – 1983 he helped to develop and nurture a robust department, focusing on recruitment, education, curriculum development, and research. The Gillies Library is named for him.
Members Of Anesthesiology Department Attend Society Of Cardiovascular Anesthesiologists Annual Meeting
April 2, 2014
This past week (March 28-April 2), Drs. Ari Balofsky, Paul Nandra, Yaser Rad, and Tarun Subrahmanian represented our department at the Society of Cardiovascular Anesthesiologists annual meeting in New Orleans, LA, and presented cases at the Complex Case Discussion session.
Dr. Rad, Dr. Subrahmanian, Dr. Carol Ann Diachun, and Dr. Andy Sifain presented the Anesthetic Management of Pre-Term Delivery in a Patient with Decompensated, Non-Ischemic Cardiomyopathy, Biventricular ICD and Bioprosthetic Tricuspid Valve.
Dr. Nandra, Dr. Subrahmanian, and Dr. Sifain presented a case of Iatrogenic Tricuspid Valve Stenosis Following a Bentall Procedure.
Dr. Balofsky, Dr. Subrahmanian, Dr. Janine Shapiro, Dr. Michael Schwartz, Dr. Todd Massey, and Dr. Sifain presented a case of Syncardia Total Artificial Heart following a Total Cardiectomy in an Orthotopic Heart Transplantation with Cardiogenic Shock.
Drs. Konstantine Tzimas, Laurent Glance, David Stern, and Michael Eaton were also in attendance.