Articles: function.
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Blood and urine tests are commonly performed by clinicians in both ambulatory and hospital settings that detect chronic and acute kidney disease. Thresholds for these tests have been established that signal the presence and severity of kidney injury or dysfunction. In the appropriate clinical context of a patient's history and physical examination, an abnormal test result should trigger specific actions for clinicians, including reviewing patient medication use, follow-up testing, prescribing lifestyle modifications, and specialist referral. Tests for kidney disease can also be used to determine the future risk for kidney failure as well as cardiovascular death.
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Minerva anestesiologica · May 2023
Randomized Controlled TrialEffect of lidocaine or dexmedetomidine on postoperative recovery in elder patients undergoing colorectal surgery.
Opioid sparing techniques have been shown to promote gastrointestinal recovery, shorten length of stay (LOS), and reduce opioid-related complications. We investigated whether intraoperative intravenous lidocaine or dexmedetomidine infusion could improve gastrointestinal recovery in elderly patients undergoing laparoscopic colorectal surgery. ⋯ Intraoperative intravenous lidocaine infusion accelerated return of the bowel function in elderly patients undergoing elective colorectal surgery.
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Randomized Controlled Trial
Randomized controlled trial of intrathecal oxytocin on speed of recovery after hip arthroplasty.
Recovery from surgery is quicker in the postpartum period, and this may reflect oxytocin action in the spinal cord. We hypothesized that intrathecal injection of oxytocin would speed recovery from pain and disability after major surgery. Ninety-eight individuals undergoing elective total hip arthroplasty were randomized to receive either intrathecal oxytocin (100 μg) or saline. ⋯ In planned secondary analyses, postoperative opioid use ended earlier in the oxytocin group and oxytocin-treated patients walked nearly 1000 more steps daily at 8 weeks ( P < 0.001) and exhibited a clinically meaningful reduction in disability for the first 21 postoperative days ( P = 0.007) compared with saline placebo. Intrathecal oxytocin before hip replacement surgery does not speed recovery from worst daily pain. Secondary analyses suggest that further study of intrathecal oxytocin to speed functional recovery without worsening pain after surgery is warranted.
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Critical care medicine · May 2023
One-Year Functional Outcomes After Invasive Mechanical Ventilation for Older Adults With Preexisting Long-Term Care-Needs.
To examine 1-year functional outcomes after invasive mechanical ventilation for adults greater than or equal to 65 years with preexisting long-term care-needs. ⋯ Among patients in preexisting care-needs levels 2-5 who received invasive mechanical ventilation, 76.0-79.2% died or had worsened care-needs within 1 year. These findings may aid shared decision-making among patients, their families, and heath care professionals on the appropriateness of starting invasive mechanical ventilation for people with poor functional and cognitive status at baseline.