Ultrasound-guided costoclavicular block as an alternative for upper limb anesthesia in obese patients

ConclusionCostoclavicular brachial plexus block is a good alternative for upper limb anesthesia distal to the elbow, being a safe and effective option for patients who are obese or have other limitations to the use of other upper limb blocking techniques.ResumoJustificativa e objetivosO bloqueio de plexo braquial via costoclavicular é uma anestesia realizada por via infraclavicular já descrita na literatura como uma via segura e efetiva para anestesia de membro superior distal ao cotovelo. O relato a seguir trata de um paciente em que as técnicas tradicionais para bloqueio de plexo apresentavam dificuldade de visibilização à ultrassonografia, já via costoclavicular foi de fácil visibilização para realização do bloqueio anestésico.Relato de casoPaciente com obesidade grau 3 a ser submetido a correção de fratura e luxação de cotovelo esquerdo apresentava anatomia da região supraclavicular distorcida à avaliação ultrassonográfica e região axilar com lesões de pele, que impossibilitavam a realização do bloqueio nessas regiões. Foi optado por realizar o bloqueio de plexo via infraclavicular no espaço costoclavicular, região onde as estruturas do plexo braquial estão mais superficiais e unidas, amparadas por uma estrutura muscular, laterais a todas as estruturas vasculares ad...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research

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We examined US sensitivity for diagnosis of HCC in obese patients. Methods: Liver transplant patients data with HCC in explant was used (January 2012-December 2017). All patients underwent liver US within 3 months of diagnosis of HCC. Number/size of HCC lesions were extracted from radiologic and pathologic reports. Obesity was defined as BMI ≥30 kg/m2. Results: One hundred sixteen patients were included. 80% were male, with mean BMI of 31 kg/m2. The most common underlying liver disease was hepatitis C virus (62%). At the time of diagnosis, median number of HCC lesions was 2 (interquartile range [IQR], 1-3), and ...
Source: Clinical and molecular hepatology - Category: Gastroenterology Tags: Clin Mol Hepatol Source Type: research
ConclusionsTaken together, these results illustrate a new model in which Purβ functions to regulate the glucagon/ADCY6/cAMP/PKA/CREB signaling pathway to help maintain glucose homeostasis.Graphical abstract
Source: Molecular Metabolism - Category: Endocrinology Source Type: research
ConclusionsLack of ALX/FPR2 induced obesity, reduced the lifespan, amplified leukocyte dysfunction, and facilitated profound inter-organ non-resolving inflammation. Our study shows the integrative and indispensable role of ALX/FPR2 in lipid metabolism, cardiac inflammation-resolution processes, obesogenic aging, and renal homeostasis.
Source: Molecular Metabolism - Category: Endocrinology Source Type: research
Publication date: Available online 15 November 2019Source: NeuroscienceAuthor(s): Clarissa M. Liu, Elizabeth A. Davis, Andrea N. Suarez, Ruth I. Wood, Emily E. Noble, Scott E. KanoskiAbstractCentral oxytocin potently reduces food intake and is being pursued as a clinical treatment for obesity. While sexually dimorphic effects have been described for the effects of oxytocin on several behavioral outcomes, the role of sex in central oxytocin modulation of feeding behavior is poorly understood. Here we investigated the effects of sex, estrous cycle stage, and female sex hormones (estrogen, progesterone) on central oxytocin-me...
Source: Neuroscience - Category: Neuroscience Source Type: research
Publication date: December 2019Source: Preventive Medicine, Volume 129Author(s): James F. Sallis, Nisha Botchwey, Myron F. Floyd, Keshia M. Pollack Porter, M. Renée Umstattd Meyer, J. Aaron Hipp, Anna Kim, Terry L. ConwayAbstractThis guest editorial introduces the rationale and goals of the Physical Activity Research Center. It provides an overview of the five papers in this Special Section plus six commissioned studies intended to inform advocacy efforts.
Source: Preventive Medicine - Category: International Medicine & Public Health Source Type: research
Objectives: To determine factors associated with nerve injury after acetabulum fracture and to evaluate recovery and outcomes. Design: Retrospective cohort study. Setting: Level 1 trauma center. Patients and Participants: Nine hundred seventy-five skeletally mature patients with acetabulum fracture. Intervention: Operative and nonoperative management. Main Outcome Measurements: Nerve injuries, categorized as traumatic or iatrogenic, recovery (none, partial, or complete), and patient-reported functional outcomes with the Musculoskeletal Function Assessment (n = 353, 36.2%). Results: Thirty-two patients (...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
ConclusionsHemodialysis patients with central obesity, as measured by the A/G ratio, had less favorable plasma lipid profiles and higher levels of inflammation but not an increased risk of ASCVD.
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
This article describes a simplified technique of endoscopic sleeve gastroplasty using the OverStitch suturing device.
Source: Gastrointestinal Endoscopy Clinics of North America - Category: Gastroenterology Authors: Source Type: research
Publication date: Available online 25 October 2019Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Lori-Ann Oliver, Jodi-Ann Oliver, Sargis Ohanyan, William Park, Aharon Benelyahoo, Nalini VadiveluPeripheral venous access is perhaps the most commonly performed procedure in hospitals, urgent care, or surgical centers across the country. The ability to obtain peripheral intravenous (IV) access, and in a timely manner, is arguably one of the most important skill sets to be mastered by health care professionals. While skill and experience play a role in successful and timely vascular access, numerous pati...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
CONCLUSION: Sweet drink consumption among preschool-age children is influenced by multiple factors across all domains of the socio-ecological model. Parents and grandparents are calling for education, healthy environments and supportive policies. SO WHAT?: Contrary to common rhetoric, children's sweet drink consumption is often influenced by factors beyond parental control. A multi-component strategy is required to support parents and grandparents in their efforts to make healthy choices for their children. PMID: 31724247 [PubMed - as supplied by publisher]
Source: Health Promotion Journal of Australia - Category: International Medicine & Public Health Tags: Health Promot J Austr Source Type: research
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