ABSTRACT
Media attention on the misuse of propofol increased significantly when the drug was implicated in the death of pop music superstar Michael Jackson in 2010. The misuse and abuse of propofol among healthcare providers has been reported worldwide, with some misuse resulting in death. Propofol policies guiding healthcare worker re-entry into the workplace after misusing propofol have received rare attention in the research literature. The paucity of information regarding propofol-specific re-entry policies suggests that little research has addressed this problem and the lack of research and policy guidance can contribute to unsafe re-entry and even death. This paper focuses on healthcare providers because they have an easy access to propofol and therefore are vulnerable to misusing or abusing the drug. To accomplish this, the pharmacology and misuse/abuse potential of propofol and the influence of the 12-step recovery paradigm in the re-entry literature are reviewed. In conclusion, existing research and policy are drawn upon to suggest employment re-entry guidelines for healthcare workers.
Subject(s)
Hypnotics and Sedatives/therapeutic use , Propofol/therapeutic use , Substance-Related Disorders , Health Personnel , Humans , Hypnotics and Sedatives/adverse effects , Propofol/adverse effects , Propofol/pharmacology , Substance-Related Disorders/rehabilitation , United StatesABSTRACT
Alignment radiographs of 174 extremities in patients undergoing total knee arthroplasty were measured to determine the variability in valgus cut angle (VCA) and the anatomical factors that affect the VCA necessary to restore the mechanical axis. The VCA averaged 5.6 degrees +/- 1.0 degrees with a range of 2 degrees to 9 degrees . With the 3 different methods of defining the anatomical axis of the femur, 30% to 51% of patients required a VCA of less than 5 degrees or greater than 6 degrees . The offset and neck-shaft angle of the ipsilateral hip exert a strong effect on the VCA necessary to restore the mechanical axis. Patients with coxa valga or reduced hip offset generally require a VCA less than 5 degrees . Patients with coxa vara or increased hip offset generally require a VCA greater than 6 degrees .
