BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e3339 (Published 16 May 2012) Cite this as: BMJ 2012;344:e3339

By analysing the pharmaceutical waste produced by eight operating rooms, an anaesthetist in New York found that discarded or wasted propofol made up 45% of all the drug waste (Anesthesia and Analgesia 2012;114:1091-2, doi:10.1213/ANE.0b013e31824ea491). Future wastage was reduced by removing 50 mL and 100 mL vials of propofol from the pharmacy, and retaining only the smallest size—20 mL. This waste reduction matters—propofol does not degrade in nature, accumulates in body fat, and is toxic to aquatic life.

In patients with enlarged thoracic aneurysm the risk of sudden death due to aortic dissection (TAAD) is more than 10% annually. Diabetes is unexpectedly associated with a decreased risk of progression and rupture of abdominal aortic aneurysm and might even have a protective role in these aneurysms developing. In a case-control study in the United States, researchers reported that, after adjusting for demographic characteristics, the negative association between diabetes and TAAD remained highly significant. Furthermore, the more severe the diabetic complications, the …

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