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Genetic risk, not anesthesia exposure, impacts cognitive performance
August 05, 2009
A recent study of more than 2,000 identical twins found that medical problems early in life, rather than the neurotoxic effects of anesthesia, are likely linked to an individual's risk for developing learning disabilities. The study's findings, reported in the journal Twin Research and Human Genetics, contradict research published earlier this year, which concluded that receiving anesthesia younger than age four is associated with subsequent learning problems. Robert Althoff, M.D., Ph.D., director of behavioral genetics at the University of Vermont's UVM) Vermont Center for Children, Youth & Families, along with colleagues Meike Bartels and Dorret Boomsma from VU University in the Netherlands, examined the relationship between anesthesia exposure and cognitive performance, but controlled for genetic association by using a sample of 1,143 identical Dutch twin pairs (2,286 children total). The research team grouped the participants into children who had anesthesia exposure before age three and those who had not, in order to facilitate the identification of twin pairs where both had been exposed to anesthesia, where neither had been exposed to anesthesia, or where only one member of the pair had been exposed to anesthesia. The twins' cognitive outcomes were measured using a standardized national exam administered to all children in the Netherlands at about age 12.
"While there was a difference in cognitive outcomes between children who had been exposed to anesthesia versus children who had not, there was no difference in cognitive outcomes between identical twins where one was exposed to anesthesia and the other was not," said Althoff, who is also assistant professor of psychiatry and pediatrics at UVM. "This indicates that exposure to anesthesia is not itself associated with worse cognitive outcomes, but rather is likely a marker of risk for later learning problems."
According to the study's authors, "classical twin studies have been informative in uncovering the underlying genetic and environmental contributions to intelligence in general and to learning disabilities specifically." The team suggests that in future related studies, screening for learning problems should take place before a child undergoes surgery, in order to establish whether or not the problem is already present.
University of Vermont
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Anesthesia Secrets: with STUDENT CONSULT Access
by James Duke MD MBA (Author)
The Secrets Series® is breaking new ground again. A two-color page layout, a portable size, and a list of the "Top 100 Secrets" in anesthesia help you to better meet the challenges they face today. And, at no extra charge, you’ll also receive online access to the complete contents of the text via Elsevier’s innovative STUDENT CONSULT website. You’ll still find all of the features you rely on the Secret Series® for—a question-and-answer format, lists, mnemonics, and tables and an informal tone that make reference fast and easy. No matter what questions arise in practice or while preparing for boards, this new volume has the answers you need—in print and online. The smart way to study! Elsevier titles with STUDENT CONSULT will help you master difficult concepts and study more...
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Basics of Anesthesia: with Evolve Website (Stoelting, Basics of Anesthesia: with Evolve Website)
by Robert K. Stoelting MD (Author), Ronald D. Miller MD (Author)
Widely acknowledged as the foremost introductory text, this latest edition provides the most authoritative and complete overview of anesthesia theory and practice and continues to serve as an excellent primer on the scope and practice of anesthesiology. Superbly edited by two of the foremost experts in the field, the new edition is presented in full color and includes updated information on new and rapidly changing areas in anesthesia practice. The new topics include Approach to Learning Anesthesia; Medical Informatics; Basic Cardiopulmonary Physiology; Hemostasis; Congenital Heart Disease; Trauma; Bioterrorism; and Medical Direction in the Operating Room.
Comprehensive coverage of the basic science and clinical topics in anesthesiologyIncludes pathophysiology, pharmacology,...
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Clinical Anesthesia (Clinical Anesthesia (Barash))
by Paul G Barash (Editor), Bruce F Cullen (Editor), Robert K Stoelting (Editor), Michael Cahalan (Editor), M. Christine Stock (Editor)
The premier single-volume reference in the field of anesthesia, Clinical Anesthesia is now in its Sixth Edition, with thoroughly updated coverage, a new full-color design, and a revamped art program featuring 880 full-color illustrations. More than 80 leading experts cover every aspect of contemporary perioperative medicine in one comprehensive, clinically focused, clear, concise, and accessible volume. Two new editors, Michael Cahalan, MD and M. Christine Stock, MD, join Drs. Barash, Cullen, and Stoelting for this edition. A companion Website will offer the fully searchable text, plus access to enhanced podcasts that can be viewed on your desktop or downloaded to most Apple and BlackBerry devices. "Doody's Core Titles 2009."
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Stoelting's Anesthesia and Co-Existing Disease: Expert Consult: Online and Print (Expert Consult Title: Online + Print)
by Roberta L. Hines MD (Author), Katherine MD Marschall MD (Author)
Today's leading authorities present the succinct, yet thorough guidance you need to successfully avoid or manage complications stemming from pre-existing medical conditions. Organized by disease, the new edition of this popular guide has been completely revised and updated to reflect the latest information on definition, current pathophysiology, significant pre-, intra-, and postoperative factors of the disease process, anesthetic judgment, and management. A new, more user-friendly design and organization-and completely redrawn illustrations-make reference easier than ever. And now, as an Expert Consult title, this reference includes access to the complete contents online, for convenient reference where and when you need it!
Offers comprehensive guidance from respected authorities...
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Miller's Anesthesia: Expert Consult Premium Edition - Enhanced Online Features and Print, 2-Volume Set
by Ronald D. Miller MD (Author), Lars I. Eriksson (Author), Lee A. Fleisher MD (Author), Jeanine P. Wiener-Kronish MD (Author), William L. Young (Author)
From fundamental principles to advanced subspecialty procedures, Miller's Anesthesia covers the full scope of contemporary anesthesia practice. It is the go-to reference for masterful guidance on the technical, scientific, and clinical challenges you face. Now, new chapters, new authors, meticulous updates, an increased international presence, and a new full-color design ensure that the 7th edition continues the tradition of excellence that you depend on. And, as an Expert Consult title with enhanced online features, this meticulously updated 7th edition comes with easy access to the full text online, regular updates, video demonstrations, and more at www.expertconsult.com.
Covers the full scope of contemporary anesthesia practice in just two volumes. Offers step-by-step...
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Clinical Anesthesia Procedures of the Massachusetts General Hospital: Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School
by Peter F Dunn (Editor), Theodore Alston (Editor), Keith Baker (Editor), J. Kenneth Davison (Editor), Jean Kwo (Editor)
Relied on for over 20 years by resident and practicing anesthesiologists and CRNAs, this best-selling pocket reference is now in its Seventh Edition. In easy-to-scan outline format, it provides current, comprehensive, concise, consistent, and clinically relevant guidelines for anesthesia procedures throughout the preoperative, intraoperative, and postoperative periods and in the ICU. The book has been written, reviewed, updated, and field-tested by the internationally recognized anesthesia department of the Massachusetts General Hospital. This edition includes new information on quality assessment, patient safety, the electronic medical record, and new techniques and medications. A new design makes information easier to access. An alphabetical drug appendix is also included. A PDA...
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Pocket Anesthesia (Pocket Notebook Series)
by Richard D Urman (Editor), Jesse M Ehrenfeld (Editor)
Designed for easy transport and quick reference, this new addition to the Pocket Notebook Series presents essential information that residents, anesthesiologists, CRNAs, and medical students need on the wards and in the operating room. Edited by anesthesia faculty at Harvard Medical School, Pocket Anesthesia is ideally suited for today's fast-paced anesthesia environment—it is concise, easy to read, and evidence-based. Essential information is presented in a well-organized schematic outline format with many tables, algorithms, and diagrams. The book is filled with must-know facts about drugs, frequent intraoperative problems, differential diagnosis, common disease states, patient evaluation, and anesthetic considerations for each subspecialty.
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Avoiding Common Anesthesia Errors (Lippincott Williams & Wilkins Handbook)
by Catherine Marcucci (Editor), Norman A Cohen (Editor), David G Metro (Editor), Jeffrey R Kirsch (Editor)
This pocket book succinctly describes 215 common, serious errors made by attendings, residents, fellows, CRNAs, and practicing anesthesiologists in the practice of anesthesia and offers practical, easy-to-remember tips for avoiding these errors. The book can easily be read immediately before the start of a rotation or used for quick reference. Each error is described in a quick-reading one-page entry that includes a brief clinical scenario, a short review of the relevant physiology and/or pharmacology, and tips on how to avoid or resolve the problem. Illustrations are included where appropriate. The book also includes important chapters on human factors, legal issues, CPT coding, and how to select a practice.
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Clinical Anesthesia: Near Misses and Lessons Learned
by John G. Brock-Utne (Author)
Although near-miss situations are relatively rare in anesthesiology, it is essential to know how to respond if the situation arises. This collection of actual cases, compiled from the author's 30+ years practice in major metropolitan hospitals in the US, Sweden and South Africa, is an excellent review of potential problems and solutions all anesthesiologists should be familiar with. The cases are succinct, with the problem and a solution described, then concluded by a retrospective analysis that examines whether the solution used was actually the best (or only) choice, or if other solutions might provide equally satisfactory outcomes. Also included in the analyses are tips to help avoid the problem altogether, when possible. This book is an excellent review for the ABA oral exam and is an...
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Anesthesia Unplugged (Gallagher, Anesthesia Unplugged)
by Christopher Gallagher (Author), Ricardo Martinez-Ruiz (Author), David Lubarsky (Author)
Sharpen the procedural skills necessary for the optimal care of the anesthetized patient Featuring an easy-to-navigate, atlas-oriented format, Anesthesia Unplugged gives you lightning-fast access to the entire spectrum of perioperative, ambulatory, regional, and general procedures. More than any other text, Anesthesia Unplugged disarmingly demystifies anesthesiology, as the book's authors and contributors take you on a engaging, yet educational voyage to places like “Intravenous World” (Part I), “Arterial Land” (Part II), and “Efficiency-Ville” (Part V). What's more, the book's comprehensive coverage is supported every step of the way by a skill-building, profusely illustrated art program. Features: Authoritative, complete, and...
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