Articles: cations.
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Anesthesia and analgesia · Mar 2023
ReviewPro and Con: How Important Is the Exact Location of Adductor Canal and Femoral Triangle Blocks?
In this Pro-Con commentary article, we debate the importance of anterior thigh block locations for analgesia following total knee arthroplasty. The debate is based on the current literature, our understanding of the relevant anatomy, and a clinical perspective. ⋯ The Pro side of the debate supports the view that more distal block locations in the anterior thigh increase the risk of excluding the medial and intermediate cutaneous nerves of the thigh and the nerve to the vastus medialis, while increasing the risk of spread to the popliteal fossa, making distal femoral triangle block the preferred location. The Con side of the debate adopts the view that while the exact location of local anesthetic injection appears anatomically important, it has not been proven to be clinically relevant.
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Anesthesia and analgesia · Mar 2023
Proteomics for the Discovery of Clinical Delirium Biomarkers: A Systematic Review of Major Studies.
Delirium represents a significant health care burden, diagnosed in more than 2 million elderly Americans each year. In the surgical population, delirium remains the most common complication among elderly patients, and is associated with longer hospital stays, higher costs of care, increased mortality, and functional impairment. The pathomechanism of disease is poorly understood, with current diagnostic approaches somewhat subjective and arbitrary, and definitive diagnostic biomarkers are currently lacking. ⋯ The most frequently identified biomarker was interleukin-6 (IL-6). By reviewing the distribution of protein biomarker candidates from these studies, we conclude that a panel of proteins, rather than a single biomarker, would allow for discriminating delirium cases from noncases. The paucity of hypothesis-generating studies in the peer-reviewed literature also suggests that a system-biology view of delirium pathomechanisms has yet to fully emerge.
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Chest radiography (CXR) continues to be the most frequently performed imaging examination worldwide, yet it remains prone to frequent errors in interpretation. These pose potential adverse consequences to patients and are a leading motivation for medical malpractice lawsuits. ⋯ The medicolegal implications of such errors are explained. Awareness of commonly missed CXR findings, their causes, and their consequences are important in developing approaches to reduce and mitigate these errors.
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Currently, little is known about the prognostic value of tumor growth rate (TGR) in spinal giant cell tumors of bone (GCTB). ⋯ These data support the use of TGR as a reliable predictive tool for clinically relevant outcomes and response to denosumab therapy of spinal GCTB, which may be helpful in guiding prognostic risk stratification and therapeutic optimization of patients.
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Minerva anestesiologica · Mar 2023
Long-term effects of Coronavirus 2 infection after intensive care: a prospective study.
While the multi-organ manifestations of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection are now well-documented, the potential long-term implications of these manifestations remain to be uncovered. The aim of the study was to study the level and predictors of post-traumatic stress, anxiety and depression symptoms, quality of life and functional disability in COVID-19 survivors during the first year post Intensive Care Unit (ICU) discharge. ⋯ Our results show that functional and cognitive recovery improves between six and 12 months after ICU discharge with a high perception of the patients' quality of life. These results will help to inform health system planning and the development of multidisciplinary strategies to reduce chronic health loss among individuals with COVID-19.