Articles: function.
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Reg Anesth Pain Med · Mar 2015
Review Meta AnalysisObesity and Chronic Pain: Systematic Review of Prevalence and Implications for Pain Practice.
The combination of obesity and pain may worsen a patient's functional status and quality of life more than each condition in isolation. We systematically searched PubMed/MEDLINE and the Cochrane databases for all reports published on obesity and pain. The prevalence of combined obesity and pain was substantial. ⋯ Screening for obesity, pain-related disability, and behavioral disorders as well as monitoring of functional performance should become routine in pain medicine practices. Such an approach requires additional physician and staff training. Further research should focus on better understanding the interplay between these 2 very common conditions and the development of effective treatment strategies.
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Anesthesia and analgesia · Mar 2015
Comparative StudyThree-Dimensional Versus Two-Dimensional Echocardiographic Assessment of Functional Mitral Regurgitation Proximal Isovelocity Surface Area.
The geometric shape of the mitral regurgitation (MR) proximal isovelocity surface area (PISA) is conventionally assumed to be a hemisphere (HS). However, in functional MR, PISA is frequently neither an HS nor a hemiellipse (HE) but is often asymmetric and crescent shaped. We used 3-dimensional transesophageal echocardiographic (3D TEE), full-volume data sets to directly measure the PISA and subsequently compared calculated values of effective regurgitant orifice area (EROA) with conventional 2D TEE techniques. EROA calculations from all PISA measurements were finally compared with the cross-sectional area at the vena contracta, a well-validated reference measure of the functional MR orifice area. ⋯ Quantitative assessment of functional MR severity by 3D TEE may be superior to 2D methods by permitting more direct measures of PISA. Two-dimensional TEE techniques for assessing functional MR severity that rely on an HS- or HE-PISA shape may underestimate the EROA due to geometric assumptions that do not account for asymmetry.
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Acta Anaesthesiol Scand · Mar 2015
Randomized Controlled TrialAcute kidney injury with hydroxyethyl starch 130/0.42 in severe sepsis.
We aimed to detail the effects of hydroxyethyl starch (HES) vs. Ringer's on kidney function including the interaction with mortality in post-hoc analyses as resuscitation with HES 130/0.42 increased mortality in the Scandinavian Starch for Severe Sepsis/Septic Shock (6S) trial. ⋯ In patients with severe sepsis, HES appeared to increase the rate of severe AKI and use of RRT within the first 5 days. The increased mortality observed with HES may have been partly mediated through acute kidney impairment.
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Anesthesia and analgesia · Mar 2015
Perioperative neurotoxicity in the elderly: summary of the 4th international workshop.
To learn the latest developments in the various forms of postoperative cognitive dysfunction, a group of scientists and physicians met in Stockholm for a full day of presentations and interactive discussions. This article summarizes the discussion; highlighting progress, challenges, and new directions in the area of perioperative neurotoxicity in our aging population.