Trending Articles
-
Current drug targets · Feb 2013
ReviewCan we delay the accelerated lung aging in COPD? Anti-aging molecules and interventions.
Chronic obstructive pulmonary disease (COPD) has been recently characterized as a disease of accelerated lung aging. The prevalence of COPD is age-dependent suggesting an intimate relationship between the pathogenesis of COPD and aging. Lung function decline, the hallmark feature of COPD evolution, is more prominent with increasing age and this decline is greater in smoking individuals. ⋯ The above mechanisms have been associated with the accelerated lung aging in COPD patients. Numerous therapeutic interventions have been studied in an attempt to reverse accelerated lung aging, and some of them have already been tested in clinical trials. The aim of the present review is to summarize the mechanisms associated with the accelerated lung aging in COPD and to provide information about the possible therapeutic implications targeting those mechanisms.
-
J Bone Joint Surg Am · Oct 2011
Comparative StudyComparison of patient-reported and clinician-assessed outcomes following total knee arthroplasty.
Although the necessity of long-term follow-up after total knee arthroplasty is unquestioned, this task may become burdensome as greater numbers of total knee arthroplasties are performed. We sought to use comparisons with clinician-assessed values to determine whether patients could reliably assess their own outcome with use of a combination of American Knee Society Score and Oxford Knee Score questionnaires and self-reported knee motion. We hypothesized that patients would self-report worse pain and function and a similar range of knee motion than clinicians would. ⋯ Patients' self-reported American Knee Society pain and function subscores were worse than the corresponding clinician assessments, but the two Oxford Knee Scores were similar. Range of knee motion may reasonably be self-assessed by comparison with photographs. Long-term follow-up of patients after total knee arthroplasty may be possible with use of patient-reported measures, alleviating the burden of clinic visits yet maintaining contact, but further studies involving other validated instruments is warranted.
-
Anesthesia and analgesia · Aug 2010
Randomized Controlled Trial Comparative StudyThe effect of intraoperative dexmedetomidine on postoperative analgesia and sedation in pediatric patients undergoing tonsillectomy and adenoidectomy.
The immediate postoperative period after tonsillectomy and adenoidectomy, one of the most common pediatric surgical procedures, is often difficult. These children frequently have severe pain but postoperative airway edema along with increased sensitivity to the respiratory-depressant effects of opioids may result in obstructive symptoms and hypoxemia. Opioid consumption may be reduced by nonsteroidal antiinflammatory drugs, but these drugs may be associated with increased bleeding after this operation. Dexmedetomidine has mild analgesic properties, causes sedation without respiratory depression, and does not have an effect on coagulation. We designed a prospective, double-blind, randomized controlled study to determine the effects of intraoperative dexmedetomidine on postoperative recovery including pain, sedation, and hemodynamics in pediatric patients undergoing tonsillectomy and adenoidectomy. ⋯ The total postoperative rescue opioid requirements were similar in tonsillectomy patients receiving intraoperative dexmedetomidine or morphine. However, the use of dexmedetomidine 1 microg/kg and morphine 100 microg/kg had the advantages of an increased time to first analgesic and a reduced need for additional rescue analgesia doses, without increasing discharge times.
-
Comparative Study
Lymphomas and glioblastomas: differences in the apparent diffusion coefficient evaluated with high b-value diffusion-weighted magnetic resonance imaging at 3T.
As the usefulness of the apparent diffusion coefficient (ADC) obtained from diffusion-weighted images (DWI) for the differential diagnosis between glioblastoma and primary central nervous system lymphoma is controversial, we assessed whether high b-value DWI at b 4000 s/mm(2) could discriminate between glioblastoma and lymphoma. We also compared the power of high- and standard b-value (b-4000, b-1000) imaging on a 3-Tesla (3T) magnetic resonance (MR) instrument. ⋯ Calculating the ADC value is useful for distinguishing lymphoma from glioblastoma. The lowest degree of overlapping and a better inverse correspondence with tumor cellularity were obtained with ADC(MIN) at b-4000 s/mm(2) at 3T MRI.
-
Clin. Orthop. Relat. Res. · Aug 2012
Reason for revision influences early patient outcomes after aseptic knee revision.
Revision TKA less consistently produces improvements in clinical function and quality of life when compared with primary TKA. The reasons for this difference are unclear. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.