Articles: cations.
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Lumbar disc herniation, canal stenosis, and cervicarthrosis are degenerative spinal pathologies frequently observed in the aging population of patients with Parkinson disease (PD). Spinal surgery in PD patients remains risky with uncertain functional results. The main issue is to determine whether a surgical procedure should be performed on PD patients with common degenerative spinal pathologies. ⋯ Noninstrumented or simple fusion level spinal surgery for patients with PD is fraught with numerous complications and produces very poor functional results. Nevertheless, a multidisciplinary perioperative approach for patients, with less invasive surgery whenever possible, provides the necessary conditions to ensure surgical success and avoid aggravating their fragile general condition.
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Semin Respir Crit Care Med · Jan 2025
Vaccination Against Respiratory Infections in the Immunosenescent Elderly: challenges and opportunities.
Respiratory infections are associated with a huge burden of disease every year and disproportionately affect older adults, namely those aged 65 years and older. Older adults are at increased risk of infections compared with their younger counterparts, and once infected, have a higher risk of experiencing severe disease course, complications, and long-term sequelae. ⋯ We then review some of the challenges facing immunization of older adults, namely immunosenescence, inflammaging, and low vaccine uptake. Next, potential opportunities for overcoming these challenges are reviewed, including the use of higher antigen doses and/or adjuvants in vaccine formulations for older adults, and the potential of multiomics analyses to improve development, performance, and implementation of vaccines.
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Anesthesia and analgesia · Jan 2025
Perioperative Pain Management in Patients With Cancer-Related Pain: A Narrative Review.
The number of cancer patients, cancer survivors, and cancer surgeries is expected to continue to grow and anesthesiologists will benefit from having a framework on how to approach treating perioperative pain in the oncologic population. This article presents general considerations for formulating a perioperative pain management plan including cancer-specific contraindications for epidurals and nerve blocks, common procedures for pain after thoracic and abdominal surgeries, and alternative pain management techniques.