 | Gaming and Visualization for Medicine Moore and Bencke Peter Moore and Elizabeth Bencken, "Center for Virtual Care" Clinical/Research Interests Dr. Moore's clinical and research interests involve cardiovascular and thoracic anesthesia, as well as lung transplant anesthesia, subjects on which he has published widely in books and journals. He also has conducted research investigating hypertonic saline, airway thermal volume in humans and its relation to body size, and the effects of calcitonin-gene related peptide (CGRP) and adenosine on regional coronary conductance in dogs with ventricular pacing. Title: Professor Chair of Anesthesiology Specialty: Anesthesiology, Pain Medicine Address: Lawrence J. Ellison Ambulatory Care Center 4860 Y St., Suite 2700 Sacramento, CA 95817 Phone: (916) 734-7246 Undergraduate Education: University of Sydney Sydney, New South Wales B.S. 1972 Medical Education: University of Sydney Sydney, New South Wales M.D. 1972 Other Education: University of Newcastle Callaghan, New South Wales Ph.D. 1991 Residency: Royal Brisbane Hospital Brisbane, Australia 1972 Royal Newcastle Hospital Newcastle, Australia 1973 Fellowships: Royal Australasian College of Surgeons Melbourne, Australia 1977 Australian and New Zealand College of Anaesthetists Melbourne, Australia 1992 Professional Memberships: American Association for the Advancement of Science American Medical Association American Society of Anesthesiologists American Society of Echocardiography Association of Anesthesia Clinical Directors Association of Anesthesiology Program Directors & Society of Academic Anesthesiology Chairs Association of University Anesthesiologists International Anesthesia Research Society Society of Cardiovascular Anesthesiologists Select Recent Publications: Porges, W.L., Hennessy, E.J., Quail, A.W., Cottee, David B.F., Moore, P.G. Mcllveen, S.A., G.H. Parsons and S.W. White. Heart-Lung interactions: The sigh and autonomic control in the bronchial and coronary circulations. Clinical and Experimental Pharmacology and Physiology (2000) 27, 1022-1027. Cottee, D.B., Quail, A., Porges, W.L., P.G. Moore and S.W. White. Effects of anaesthesis on regional coronary control mechanisms. Clinical and Experimental Pharmacology and Physiology (2000) 27, 1034-1038. P.G. Moore, Quail, A. W., Cottee, D.B., Mcllveen S.A., and White, S.W. Effect of Fentanyl on baroreflex control of circumflex coronary conductance. Clinical and Experimental Pharmacology and Physiology, (2000) 27, 1034-1038. Kien ND, Reitan JA, Moore PG. Hypertonic Saline Seminars in Anesthesia 1998;17:3 Serikov VB, Jerome EH, Fleming NW, Moore PG, Stawicke FA, Staub NC. Airway thermal volume in humans and its relation to body size Journal of Applied Physiology 1997;83:668-676 Kien ND, Moore PG, Pascual JM, Reitan JA, Kramer GC. Effects of hypertonic saline on regional function and blood flow in canine hearts during acute coronary occlusion Shock 1997;7:274-81 Kraut EJ, Owings JT, Anderson JT, Hanowell L, Moore P. Right ventricular volumes overestimate left ventricular preload in critically ill patients Journal of Trauma 1997;42:839-846 Kien ND, Antognini JF, Reilly DA, Moore PG. Small-volume resuscitation using hypertonic saline improves organ perfusion in burned rats Anesthesia and Analgesia 1996;83:782-788 Reitan, J.A., P.G. Moore, N.D. Kien, S. Lee and D.A. White. The relationship between systolic pressure and stroke volume describes myocardial contractility. j Cardiothor Vasc anesth 9:676-683, 1995. |
 | Recall of Braun Normal Saline Flush Syringes B. Braun Medical, Inc., is recalling over a million normal saline flush syringes because they may contain particles of medical grade silicone. Introducing these particles into the bloodstream could cause phlebitis and organ damage, and possibly pulmonary embolism. The risk is cumulative, and would increase with each additional exposure. The recall affects normal saline 3 mL in 12 mL syringes, product code 513584, and normal saline 10mL in 12mL syringes, product code 513587. The lot numbers of the recalled syringes end in "SFR." These syringes are used in both healthcare facilities and in caring for patients at home. Anyone with the recalled syringes should immediately discontinue using them and seek medical attention if they've experienced symptoms that may be related to the product. To arrange for replacement syringes, contact B. Braun at 800-227-2862. FDA Patient Safety News: November 2007 For more information, please see our website: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/transcript.cfm?show=69#3 |
 | Zachary's Nebulizer Treatment Zachary was diagnosed with croup and then RSV... It's been a fun, stressful time, but he seems to be getting better. He should only need this treatment for 2 weeks. He doesn't like the mask, but calms down and smiles when we sing Itsy Bitsy Spider to him. What is a nebulizer? A nebulizer is a machine that uses compressed air to deliver asthma medicine as wet aerosol, a mist that can be inhaled. Nebulizers are most often used for children younger than 5, people who have difficulty using inhalers, and those with severe asthma. Nebulizers are also used by people with chronic lung diseases, such as emphysema. The most common medications used in a nebulizer are bronchodilators (such as albuterol) to help open up air passages and inhaled steroids. Nebulizers have three main parts: a cup that holds the medication, a mouthpiece or mask attached to a "T"-shaped part, and a thin, plastic tube that connects the mouthpiece to the compressor. There are home and hospital models of nebulizers, as well as portable units. The portable machines run on batteries or can be plugged into your car's cigarette lighter. How to use a nebulizer Read the equipment instructions completely before using your nebulizer, because directions vary from one manufacturer to another. The medication solution that you will use in an aerosol machine may come in a multi-dose bottle with a dropper, or in a small plastic vial. Steps for using a nebulizer: Wash your hands prior to preparing each nebulizer treatment, and make sure the equipment is clean. If using a multi-dose bottle of medicine, use the dropper to put the correct amount of medication into the cup with saline solution. If your medicine is in single-use vials, twist open the top of the plastic vial and then squeeze the contents into the nebulizer cup. Connect the mouthpiece to the T-shaped part and then fasten this unit to the cup, or fasten the mask to the cup. It is recommended that children older than 2 years old use a mouthpiece because it will deliver more medication than the mask. Connect the nebulizer tubing to the port on the compressor. Hold the nebulizer in an upright position to prevent spilling. While sitting in a comfortable, upright position place the mouthpiece between your teeth and close your lips around it. Or, put on the mask, making sure it fits well so mist won't go into your eyes. Turn the compressor on and check the nebulizer for misting. When using a finger valve, cover the air hole to force the air into the nebulizer. If you are not using a finger valve, the nebulizer will mist continually. Gently breathe out. As the mist starts, inhale slowly and deeply through your mouth, taking over three to five seconds for each breath, while keeping your finger over the valve hole. At the end of a deep breath, uncover the finger valve hole to stop the mist. Hold your breath for up to 10 seconds before exhaling. This allows the medication time to deposit in the airway. Continue until the medicine is gone from the cup (about five minutes). Occasionally tapping the side of the nebulizer helps the solution drop to where it can be misted. Treatment is finished when all the medication has been used from the container. The nebulizer will most likely begin sputtering when it is empty. Store the medication as directed. How to clean a nebulizer Clean the nebulizer regularly to keep the equipment from clogging and to help it last longer. Cleaning also helps prevent germs that can cause infection. Follow the manufacturer's instructions for cleaning and storage. Not all nebulizer parts are dishwasher safe. After each use: Remove the mask or mouthpiece and T-shaped part from the cup. Remove the tubing and set it aside. The tubing should not be washed or rinsed. Rinse the mask or mouthpiece and T-shaped part in warm, running water for 30 seconds. Use distilled or sterile water for rinsing, if possible. Shake off excess water and air dry on a clean cloth or paper towel. Put the mask or mouthpiece and T-shaped part, cup, and tubing back together, and connect the device to the compressor. Run the machine for 10 to 20 seconds to dry the inside of the nebulizer. Disconnect the tubing from the compressor. Make sure the nebulizer is dry before storing the nebulizer in a sealed plastic bag. Place a cover over the compressor. |
 | For Your Health - Breakthroughs in Trauma In this episode of For Your Health, breakthroughs in trauma care, including polyheme research that can be used by paramedics in the field in place of saline and new dissolvable bandage technology that controls bleeding and prevents infection are featured. Then, Dr. Deborah German, the dean of UCF's new medical school discusses the scholarship program for the inaugural class of medical students and what makes the UCF College of Medicine unique. Finally, new technologies in physical therapy are explored, including state of the art wheelchairs that can climb stairs and pressure mapping cushions that help determine what is needed for skin integrity. |
 | Nancy Today: An IV saline lock All about getting an introvenus saline lock |
 | Compartment Syndrome Pressure Gauge To diagnose compartment syndrome in the two posterior muscle compartments of my lower legs, a large needle is used. First the doctor anesthetizes the area, then pushes the needle in until it punctures the fasciae. You can see when this happens in the video -- twice for each leg, though you only see one leg gauged here. The needle pushes then pops through, and I probably flinch :p. I am anesthetized, but still can feel the pressure. It doesn't hurt at first, but is distinctly uncomfortable, and once the needle goes deep into my leg, I can really feel it. Saline is injected into the muscle compartment, and the back pressure is recorded in mmHg (millimeters mercury.)This is done before working out/aggravating the syndrome, and again afterwards. When the doctor says at the end, "41 and 39, 38 and 30," he's telling me what the pressure reading was at the end of the appointment. Prior to working out, the pressure readings were between mostly between 15 and 18 mmHg. |
 | Denver Breast Augmentation http://www.millardplasticsurgery.com John A. Millard, M.D. is a Denver plastic surgeon who offers silicone breast implants to his patients. With the recent approval of silicone by the FDA, these implants been proven to be safe for the patient. Tested and studied rigorously during the 14 year ban, silicone implants are now recommended for women who are over 22 years old and seeking breast augmentation. Silicone implants look and feel more natural, and the texture of the implant is smoother than that of the saline implant surface. Even if the silicone implant ruptures, the memory gel inside of the implant will stay in place. As with any medical device placed within the body, there is always a possibility that it may need to be replaced at some point. To ensure that the silicone breast implants are doing well inside of your breasts, it is recommended that you have a one, three, and 10 year follow up, and get an MRI every two to three years. To learn more about silicone breast implants, please visit Dr. Millard's Web site. |
 | Breast Augmentation -- Wilmington and Newark, Delaware http://www.drabdollahmalek.com -- Breast augmentation, performed at our Newark office near Wilmington, Delaware can increase the size of breasts, improve the contours of the body and can boost confidence. Using saline or silicone breast implants and several types of incisions, Dr. Abdollah Malek can give you the beautiful curvaceous body you desire. To learn more about breast enhancement, visit our website at http://www.drabdollahmalek.com. You may contact Dr. Abdollah Malek at: Centre for Cosmetic Surgery Abby Medical Center One Centurian Dr., Suite 301 Newark, DE 19713 Phone: 866.456.5585 Website: http://www.drabdollahmalek.com |
 | Atlanta Plastic Surgery -- Silicone and Saline Breast Implant http://www.tomlintnermd.com -- At our office, Dr. Thomas Lintner offers silicone and saline breast implants to Atlanta-area patients. At his offices in Marietta and Woodstock, Dr. Lintner provides natural, beautiful results for breast augmentation. Breast implants can also be placed along with a breast lift to improve the height and shape of the bust, as well. Visit our website at http://www.tomlintnermd.com to learn more about breast augmentation, or to contact Dr. Lintner. You may contact Dr. Thomas B. Lintner at: Marietta 711 Canton Rd Suite 400 Marietta, Georgia 30060 Woodstock 120 N. Medical Parkway Suite 200 Woodstock, Georgia 30189 Phone: 770-771-5151 Website: http://www.tomlintnermd.com |
 | Insidermedicine in 60 - September 12, 2007 From Buffalo - In a dramatic turn of events, the Buffalo Bills tight end Kevin Everett has been able to move his arm and legs. After suffering a C3/4 vertebral fracture, his doctors initially painted a grim picture. The key to recovery was the decision to use an ice-cold saline solution through Everett's system that put the player in a hypothermic state. From Montreal - While breast feeding has many benefits, lowering the risk for asthma and allergies may not be one of them. According to research of nearly 14,000 children, those whose mothers breast fed for longer periods of time had no lower risk of developing asthma or allergies at age 6. From Maryland - Eating vegetables that are rich in lutein and zaexanthin is good for the eyes. New research shows that those who had ate high levels of these compounds- found in spinach, squash and broccoli- liwred the risk of having advanced macular degeneration. And finally from New York - Once hailed as a breakthrough in potentially reducing medical errors and tracking Alzheimer's patients, the RFID chip may be linked to cancer. Research on the animals who received the chip, which contains both a transponder and circuitry to contain patient information, suggests a higher risk for soft-tissue tumors. For Insidermedicine in 60, I'm Dr. Susan Sharma. |
 | Ajay Kumar, MD. Saline or Gel? |
 | Blood substitutes http://www.noblood.org/news-hot-topics-such-hepatitis-c-sars-aids/4304-exclusive-san-antonios-first-bloodless-hospital.html he Trouble Shooters are breaking big medical news. We have learned San Antonio is about to get its first bloodless hospital. That means it will be performing surgeries without giving blood transfusions. In part, because blood is always in such short supply in our area. News 4 Trouble Shooter Jaie Avila has the exclusive details on something many patients didn't realize was possible. Blood transfusions are standard practice during many surgeries, but now a local hospital says it can do even complicated, open-heart procedures without transfusing blood. It says the surgeries are safe, less expensive and the patients recover faster. Northeast Baptist Hospital says this is not a medical trial. It is converting the entire hospital into a bloodless facility, with a goal of performing 90% of its surgeries without blood. How is that possible? Take the case of Raymond Talbert, who is legally blind, and needs one of his heart valves replaced or he could die. Talbert cannot receive a blood transfusion because of his religious beliefs. "Because I'm a Jehovah's Witness, I do not take blood, so they recognize that and they respect that so it pleases me immensely." In the days before the surgery, Talbert's surgeon, Dr. Jerry Kelley, tries to conserve Talbert's own blood by drawing as little of it as possible for testing. "In the past, you would take a big tube of blood," explains Dr. Kelley. "Now, we're using very small tubes and basically, every test that we're ordering now, we're thinking, 'Do we really need this test? Or can we go by the results we had yesterday?'" Talbert is also given iron and a special drug to build up his blood cell count in advance of the surgery. "My faith is strong, I have no questions about doing it this way, and the technology is there to do it," says Talbert. While performing the operation, Dr. Kelley cauterizes blood vessels as he goes, to minimize bleeding. What blood is lost, goes into a special machine called a cell saver, which filters raymond's blood, and routes it directly back into his veins. They also dilute Talbert's blood with a saline solution, to increase the volume of blood in his body. Bloodless hospitals in other parts of the country have been using these techniques for years. "This is nothing experimental. These are procedures being done other places," adds Dr. Kelley. "We have data from around the country to support everything we're doing here." In fact, Northeast Baptist Hospital has the support of the South Texas Blood & Tissue Center, which says bloodless medicine could help reduce demand for donated blood. "If a hospital can utilize bloodless medicine and reduce usage in elective surgeries, then that helps trauma patients and surgeries that go unscheduled, to be able to have blood available," says Dr. Rachel Beddard with the South Texas Blood & Tissue Center. Another heart patient, Larry Harber, has no religious objection to blood. The former firefighter is more concerned about possible infections or complications from receiving donated blood. "You always have that thought, 'I would prefer to keep my own blood, as opposed to have someone else's blood'," says Harber. Northeast Baptist Hospital hopes by going bloodless, it will no longer have to delay or cancel surgeries due to a shortage of donated blood. And the move could save the hospital hundreds of thousands of dollars a year. Just one unit of donated blood can cost a hospital more than $700. By the time the hospital matches the blood and does the transfusion, the cost to the patient can jump to $1,500 or more. "It's cheaper all the way around," says Dr. Kelley. "The hospital bill's going to be less. You have less chance of having a problem with the blood, and you heal faster, you heal better." That seems to have been the case with Raymond Talbert. He was able to leave the hospital four days after his heart surgery. Northeast Baptist says other patients who received the same procedure with blood transfusions spent 15 to 22 days in the hospital. The average cost of a heart surgery without blood is $16,435. With blood transfusions, the same surgery costs $23,415. "I feel good about it, I feel positive about it, I'm physically well, I'm alive. I'm not doing any marathons today but I'm here," says Talbert. Doctors will still be able to give a transfusion if they feel it is medically necessary, or if the patient asks for it, but now when a patient first checks in to the hospital they will automatically be told about the benefits of bloodless surgery. Alternativas médicas ao sangue Künstliches Blut 無血手術 Tratamientos alternativos a las transfusiones de sangre Blood substitutes Substitut sanguin 代替血液 Vér nélküli sebészet Recuperação intra-operatória de sangue Intraoperative blood salvage |
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