Articles: function.
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Minerva anestesiologica · Jan 2017
ReviewThe link between anesthesiology and neurology: a mindful cooperation to improve brain protection.
Preventing neurological injury is mandatory during the perioperative period of any kind of surgery and in the care of critically ill patients in the intensive care unit. During daily practice, both anesthesiologists and neurologists focus on brain protection as an integral part of systemic homeostasis maintenance. This article highlights the intriguing overlap between anesthesiology and neurology in clinical practice along with its potential implications for outcome. ⋯ Clinical vigilance and the use of shared monitoring and diagnostic technology could allow early recognition and treatment of cerebral dysfunction occurring in the perioperative period or in the critical care setting, thus reducing morbidity and mortality. In order to improve patient safety and outcome, neurologists and anesthesiologists should more closely and successfully collaborate, using shared monitoring tools and integrating traditional areas of expertise. Daily activity, education, research and training programs in anesthesia and neurology could benefit from a stronger relationship with each other.
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Despite the high number of studies evaluating the outcomes following tibial shaft fractures, the literature lacks studies including objective assessment of patients' recovery regarding gait pattern. The purpose of the present study was to evaluate whether gait patterns at 6 and 12 months post-operatively following intramedullary nailing of a tibial shaft fracture are different compared with a healthy reference population. ⋯ In patients treated by intramedullary nailing following a tibial shaft fracture, gait asymmetry accompanied with slower speed and cadence are common during the first 6 months and become normalized compared with a healthy reference population between 6 and 12 months post-operatively.
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Asthma and COPD are common airway diseases. Individuals with overlapping asthma and COPD experience increased health impairment and severe disease exacerbations. Efficacious treatment options are required for this population. Omalizumab (anti-IgE) therapy is effective in patients with severe persistent asthma, but limited data are available on efficacy in populations with overlapping asthma and COPD. ⋯ Our study suggests that omalizumab improves asthma control and health-related quality of life in individuals with severe allergic asthma and overlapping COPD. These findings provide real-world efficacy data for this patient population and suggest that omalizumab is useful in the management of severe asthma with COPD overlap.
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Cochrane Db Syst Rev · Jan 2017
Prophylactic platelet transfusions prior to surgery for people with a low platelet count.
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the clinical effectiveness and safety of prophylactic platelet transfusions prior to surgery for people with a low platelet count or platelet dysfunction (inherited or acquired).
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Knowledge of how alterations in pharmacogenomics and pharmacogenetics may affect drug therapy in the intensive care unit (ICU) has received little study. We review the clinically relevant application of pharmacogenetics and pharmacogenomics to drugs and conditions encountered in the ICU. ⋯ Application of pharmacogenetics and pharmacogenomics has seen improvements in drug therapy. Ongoing study and incorporation of these concepts into clinical decision making in the ICU has the potential to affect patient outcomes.