Critical Illness and the Frailty Syndrome: Mechanisms and Potential Therapeutic Targets.

Critical Illness and the Frailty Syndrome: Mechanisms and Potential Therapeutic Targets. Anesth Analg. 2020 Jun;130(6):1545-1555 Authors: Paul JA, Whittington RA, Baldwin MR Abstract Frailty is a syndrome characterized by decreased reserves across multiple physiologic systems resulting in functional limitations and vulnerability to new stressors. Physical frailty develops over years in community-dwelling older adults but presents or worsens within days in the intensive care unit (ICU) because common mechanisms governing age-related physical frailty are often exacerbated by critical illness. The hallmark of physical frailty is a combined loss of muscle mass, force, and endurance. About one-third of ICU patients have frailty before hospitalization, which increases their risk for both short- and long-term disability and mortality. While there are several valid ways to measure clinical frailty in patients before or after an ICU admission, the mechanistic underpinnings of frailty in critically ill patients and ICU survivors have not been thoroughly investigated. Furthermore, therapeutic interventions to treat frailty during and after time in the ICU are lacking. In this narrative review, we examine studies that identify potential biological mechanisms underlying the development and propagation of physical frailty in both aging and critical illness (eg, inflammation, mitochondrial myopathy, and neuroendocrinopathy). We discuss specific aspects of these frailty...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research

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Authors: Yamanaka H, Tsukamoto M, Hitosugi T, Yokoyama T Abstract Airway management for patients with craniofacial disorders poses many challenges. Congenital infiltrating lipomatosis of the face (CILF) is an extremely rare disorder in which mature lipocytes invade adjacent tissues in the head and neck. The manifestations are typically unilateral, often with associated hypertrophy of both the hard and soft tissues of the face. This is a case report regarding the anesthetic management for a 5-year-old intellectually disabled female with CILF involving the right side of her face who underwent a successful intubated g...
Source: Anesthesia Progress - Category: Anesthesiology Tags: Anesth Prog Source Type: research
In this study, we tested the feasibility of anaesthetised fMRI in 11 patients (mean age = 9.8 years) with Lennox-Gastaut syndrome, a severe form of childhood-onset epilepsy associated with intellectual disability. fMRI was acquired during clinically-indicated MRI sessions using a synergistic anaesthesia regimen we typically administer for epilepsy neurosurgery: combined low-dose isoflurane (≤ 0.8% end-tidal concentration) with remifentanil (≤ 0.1 mcg/kg/min). Using group-level independent component analysis, we assessed the presence of resting-state networks by spatially comparing results ...
Source: Brain Topography - Category: Neuroscience Authors: Tags: Brain Topogr Source Type: research
Conclusions: A greater incidence of anterior circulation ischemic stroke, and recurrent strokes occur in patients with DM.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
CONCLUSIONS: The ultrasound-guided non-flush ligation and stripping of the great saphenous vein are as efficacious as radio frequency ablation, with similar obliteration rates, improvement in disability scores and complication profile at a lower cost. It has the potential for wider availability in the community as most surgeons are conversant with the surgical procedure. PMID: 32538106 [PubMed - as supplied by publisher]
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
Conclusions: Averaged COx ≥0.05 is independently associated with short and long-term mortality and long-term severe disability in acutely comatose adults with neurological injury. We propose that COx ≥0.05 represents an accurate threshold to predict long-term functional outcome in acutely comatose adults.
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Clinical Investigations Source Type: research
This study reported a new endoscopic discectomy strategy for the treatment of very highly migrated LDH between the L4/5 and L5/S1 level. MATERIAL AND METHODS The current study retrospectively analyzed 12 patients who accepted PELD for very highly migrated LDH between the L4/5 and L5/S1 level. Under local anesthesia, the transforaminal approach was chosen for the L4/5 level and the interlaminar approach was chosen for the L5/S1 level. The 10-point visual analogue scale (VAS) was used to assess back pain (VAS-Back) and leg pain (VAS-Leg). Oswestry disability index (ODI) and Modified Mac Nab Criteria were adopted as the funct...
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
Mosquito bites may be a nuisance, but fortunately, in the U.S., they tend to amount to nothing more than that. Upon being bitten, most Americans experience a bit of swelling and itchiness, and nothing more. However, there are exceptions to this, including stronger allergic reactions to bites and cases of mosquito-borne illness.  Insect and arachnid bites, including ticks, account for approximately 2,000 cases of malaria and 30,000 cases of Lyme disease in the U.S. annually. In addition, millions of people worldwide die of malaria each year. It is helpful to protect yourself against insect bites, not only to avoid pesk...
Source: Conversations with Dr Greene - Category: Child Development Authors: Tags: Dr. Greene's Blog Environmental Health Insect Bites & Stings Insects & Animals Outdoor Safety Source Type: blogs
Abstract Children with multiple exposures to anesthesia and surgery may be more likely to develop learning disability. Coenzyme Q10 (CoQ10) was reported to reduce the multiple sevoflurane treatment induced cognitive deficiency in 6-day old young mice. However, its specific mechanisms have not yet been found. This research aimed to reveal the role of ApoE in the pathogenesis of cognitive deficiency caused by sevoflurane anesthesia and the protective mechanism of CoQ10 in a multiple sevoflurane treatment model of young mice. The mice were randomly divided into 4 groups: Control + corn oil, Sevoflurane + corn oil, Co...
Source: International Journal of Developmental Neuroscience - Category: Neuroscience Authors: Tags: Int J Dev Neurosci Source Type: research
Condition:   Adult Patients With Intellectual and/or Physical Disabilities Requiring Dental Treatment Under General Anesthesia Intervention:   Other: No patient treatment is associated with the study Sponsor:   University of Göttingen Completed
Source: - Category: Research Source Type: clinical trials
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