Monitored anesthesia care (MAC) sedation: clinical utility of fospropofol

Fospropofol, a phosphorylated prodrug version of the popular induction agent propofol, is hydrolyzed in vivo to release active propofol, formaldehyde, and phosphate. Pharmacodynamic studies show fospropofol provides clinically useful sedation and EEG/bispectral index suppression while causing significantly less respiratory depression than propofol. Pain at the injection site, a common complaint with propofol, was not reported with fospropofol; the major patient complaint was transitory perianal itching during the drug’s administration. Although many clinicians believe fospropofol can safely be given by a registered nurse, the FDA mandated that fospropofol, like propofol, must be used only in the presence of a trained anesthesia provider

An Unusual Case of Tracheoesophageal Fistulae

Acquired tracheoesophageal fistulae (TEF) are commonly due to malignancy (M. F. Reed and D. J. Mathisen, 2003). We present the case of a patient with a deceptive history for TEF and report an approach that provides adequate oxygenation, ventilation, surgical exposure, and postoperative analgesia with excellent outcome

The Elian photo op: where TV news met street-corner politics

Describes continuous media coverage of Cuban refugee Elián González by television networks stationed outside the home of his relatives in Little Havana, and their use of the media for political purposes; 2000; Miami, Florida

Horatio Nelson: Determining the Indeterminate Military Hero

This chapter considers the case of Horatio Nelson. It evaluates the utility of the four arts in explaining the success of England's greatest admiral. It notes that Nelson's character, and presumably his leadership skill and style, have been based on loyalty. It also talks about his independence of thought and action, which was often articulated and executed at the expense of loyalty to his superior officers and to the Admiralty. It discusses the battle of Trafalgar as well as Nelson's tactics during that battle

Adolf Hitler: The Political Emotionasaurus Rex

This chapter's focus is on Adolf Hitler, as well as his Aryan race, who did more than anyone else to bring the twentieth century to its knees through mass destruction and genocide. It notes that the irony of Hitler's leadership is that mass voluntarism, not just systemic coercion, and freedom of choice, not just the limits of choice, lie deeply buried within the Nazi system. It examines the Weimar Republic and the Versailles Treaty and the National Socialist Worker's Party. It also talks about Hitler's expansion through Poland and the war against the Jews that began when von Rath, a German diplomat, was murdered by Herschel Grynszpan, a Polish Jew expelled by the Nazis. It explores the war in Europe, the Soviet Union, and the war in Germany

Henry Ford: The Blind Business Visionary

This chapter returns to the business world to look at Henry Ford, whose leadership inaugurated a qualitative leap from craft to mass production and gave rise to the term ‘Fordism’. It discusses how Ford enabled vast numbers of Americans to own cars because his prices were so low, but he persisted in assuming that price was critical long after many of his former customers had drifted away to the cars of General Motors and Chrysler, where the competitive edge was in novelty and product enhancements not simply price. It notes that Ford was a pacifist who spent a vast personal fortune leasing a ‘peace ship’ to sail to Europe and stop the First World War—but he simultaneously made an even bigger fortune with his production of munitions, boats, tanks, planes, and jeeps in both wars