Articles: function.
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Anesthesia and analgesia · Sep 2014
Cognitive Outcome after Spinal Anesthesia and Surgery During Infancy.
Observational studies on pediatric anesthesia neurotoxicity have been unable to distinguish long-term effects of general anesthesia (GA) from factors associated with the need for surgery. A recent study on elementary school children who had received a single GA during the first year of life demonstrated an association in otherwise healthy children between the duration of anesthesia and diminished test scores and also revealed a subgroup of children with "very poor academic achievement" (VPAA), scoring below the fifth percentile on standardized testing. Analysis of postoperative cognitive function in a similar cohort of children anesthetized with an alternative to GA may help to begin to separate the effects of anesthesia from other confounders. ⋯ We found no link between duration of surgery with infant SA and scores on academic achievement testing in elementary school. We also found no relationship between infant SA and surgery with VPAA on elementary school testing, although the CIs were wide.
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Reg Anesth Pain Med · Sep 2014
Observational StudyThe Incidence of Hematoma Formation in Patients With Continuous Femoral Catheters Following Total Knee Arthroplasty While Receiving Rivaroxaban as Thromboprophylaxis: An Observational Study.
Multimodal analgesia, including continuous femoral block, is often used to manage postoperative pain following total knee arthroplasty. To reduce the risk of deep vein thrombosis and pulmonary embolus formation, anticoagulation is also a part of the care for patients who undergo total knee arthroplasty. However, the concurrent use of continuous peripheral nerve block and anticoagulation can lead to hematoma formation. This prospective, single-center, observational study investigated the incidence of hematoma formation, causing neurovascular compromise, for patients with femoral catheters while taking the oral anticoagulant rivaroxaban. ⋯ In this prospective observational study, the concurrent administration of continuous femoral nerve block, the once-daily administration of the anticoagulant rivaroxaban, and the timed removal of the femoral catheter were not associated with hematoma formation resulting in neurovascular compromise at the femoral catheter insertion site or groin area.
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Critical care medicine · Sep 2014
ReviewWhen Cardiac Failure, Kidney Dysfunction, and Kidney Injury Intersect in Acute Conditions: The Case of Cardiorenal Syndrome.
To review and describe diagnostic and prognostic value of biomarkers of renal function and renal injury in the cardiorenal syndrome complicating acutely decompensated heart failure. ⋯ Biomarkers reflecting renal function and injury are likely to better phenotype subgroups of patients with cardiorenal syndrome and to provide unique prognostic information. Future studies are needed relative to strategies using such biomarkers to guide care of affected patients.
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Preventive medicine · Sep 2014
Is exercise used as medicine? Association of meeting strength training guidelines and functional limitations among older US adults.
To determine the association between meeting strength training guidelines (≥2 times per week) and the presence of functional limitations among older adults. ⋯ Strength training is uncommon among older adults and even less common among those who need it the most. The potential for strength training to improve the public's health is therefore substantial, as those who have the most to gain from strength training participate the least.
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Caveolae are a nexus for protective signaling. Trafficking of caveolin to mitochondria is essential for adaptation to cellular stress though the trafficking mechanisms remain unknown. The authors hypothesized that G protein-coupled receptor/inhibitory G protein (Gi) activation leads to caveolin trafficking to mitochondria. ⋯ Gi proteins are involved in trafficking caveolin to mitochondria to enhance stress resistance. Agents that target Gi activation and caveolin trafficking may be viable cardioprotective agents.