Ultrasound-guided multiple peripheral nerve blocks, a way out for anesthesia in morbidly obese patients for bone marrow aspiration.

We present a 59-year-old adult morbidly obese, hypertensive, diabetic female with hypothyroidism operated for proximal humerus fracture and now presented with non-union of fracture, requiring percutaneous injection of bone marrow aspirate from the iliac crest to the site of non-union. The patient was extremely anxious and refused to undergo the procedure under local anesthesia or sedation and demanded anesthesia. Given her comorbidities general anesthesia (GA) was avoided and the procedure was accomplished using Ultrasound (USG) guided Transversus abdominis plane (TAP) block and Lateral Femoral Cutaneous Nerve (LFCN) block for the bone marrow aspirate from the iliac crest and Intercostobrachial nerve block (T2) was given to prevent pain while injecting the aspirate into the non-union site. Dexmedetomidine and ketamine were given for deep level sedation and analgesia. TAP block and LFCN block is generally used for post-op analgesia but can be also used for surgical anesthesia instead of General anesthesia in specific scenarios. Its perioperative application and its potential use instead of GA have been discussed. PMID: 32475698 [PubMed - as supplied by publisher]
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research

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In this study, we examined the effect ofArnica montana andBellis perennis on seroma prevention after mastectomy and breast reconstruction.MethodsThis was a prospective double-blinded randomized analysis of 55 consecutive patients (78 breasts), who underwent mastectomy and immediate breast reconstruction between January 2016 and August 2017. Patients were randomly assigned and treated withArnica montana andBellis perennis or placebo from surgery and up to the time of drain removal.ResultsThe mean patient age was 47.9  years. Comorbidities included obesity, diabetes mellitus, essential hypertension, fibromyalgia, and hy...
Source: European Journal of Plastic Surgery - Category: Cosmetic Surgery Source Type: research
Conclusions: Quality of life increases significantly after surgery with a reduction of pain and swelling and decreased tendency to easy bruising. The high prevalence of hypothyroidism in lipedema patients could be related to the frequently observed lipedema-associated obesity. The low prevalence of diabetes, dyslipidemia, and hypertension appears to be a specific characteristic distinguishing lipedema from lifestyle-induced obesity.
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Reconstructive: Lower Extremity: Original Articles Source Type: research
AbstractPrader-Willi syndrome (PWS) is a genetic disorder characterized by short stature, low lean body mass, muscular hypotonia, mental retardation, behavioral abnormalities, dysmorphic features, and excessive appetite with progressive obesity. It is caused by lack of expression of genes on the paternally inherited chromosome 15q11.2-q13. This genetic disorder has an estimated prevalence that ranges between 1/10,000 –1/30,000. Hypothalamic dysfunction is a common finding in PWS and it has been implicated in several manifestations of this syndrome such as hyperphagia, temperature instability, high pain threshold, sle...
Source: Reviews in Endocrine and Metabolic Disorders - Category: Endocrinology Source Type: research
Abstract Prader-Willi syndrome (PWS) is a genetic disorder characterized by short stature, low lean body mass, muscular hypotonia, mental retardation, behavioral abnormalities, dysmorphic features, and excessive appetite with progressive obesity. It is caused by lack of expression of genes on the paternally inherited chromosome 15q11.2-q13. This genetic disorder has an estimated prevalence that ranges between 1/10,000-1/30,000. Hypothalamic dysfunction is a common finding in PWS and it has been implicated in several manifestations of this syndrome such as hyperphagia, temperature instability, high pain threshold, ...
Source: ENDOCR REV - Category: Endocrinology Authors: Tags: Rev Endocr Metab Disord Source Type: research
Filomena Corbo1†, Giacomina Brunetti2*†, Pasquale Crupi3, Sara Bortolotti4, Giuseppina Storlino4, Laura Piacente5, Alessia Carocci1, Alessia Catalano1, Gualtiero Milani1, Graziana Colaianni4, Silvia Colucci2, Maria Grano4, Carlo Franchini1, Maria Lisa Clodoveo6, Gabriele D'Amato7 and Maria Felicia Faienza5 1Department of Pharmacy-Drug science, University of Bari Aldo Moro, Bari, Italy 2Section of Human Anatomy and Histology, Department of Basic and Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy 3CREA-VE, Council for Agricultural Research and Economics&ndas...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusion Preclinical and clinical studies have demonstrated that treatment with antipsychotics and metformin had effects on the gut microbiota and the brain. Although the mechanism of the effects of metformin on AIMD remains unclear, there are some clues in the regulation of the gut-brain axis (Figure 1). The most important connections between metformin and AIMD in the gut microbiota were the mucin-degrading bacteria A. muciniphila and several SCFA-producing bacteria, such as the phyla Firmicutes and Bacteroidetes. The gut microbiota were was influenced during AIMD, and these changes included a decrease in A. muciniphil...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
ConclusionsThenar atrophy and sensory loss were highly specific in CTS but had limited value in early detection. Due to their low specificity, provocative tests do not appear sufficient enough to establish a definite CTS diagnosis. Only Durkan’s test could possibly be considered initially as it has more balanced values. Diabetes, obesity, rheumatoid arthritis, hypothyroidism and gout significantly increase the risk of CTS.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Amanda began the process overweight, depressed, struggling with energy, muscle and joint pains, pre-diabetic, hypertensive, and with polycystic ovary syndrome, reliant on numerous medications even in her 20s and early 30s. As you can see now, after starting with the Wheat Belly 10-Day Grain Detox, she is now slender and free of ALL her health problems and off ALL her medications. “The pic on the left is me in my 20’s, 27 to be exact. This was before I ever started my journey. “That smile was masking physical and emotional pain, suicidal ideation, PCOS, depression, hypothyroidism, ADD symptoms, fibromyalg...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: News & Updates blood pressure diabetes fibromyalgia grain-free grains hypertension Inflammation joint pain polycystic ovary pre-diabetes pros undoctored Weight Loss wheat belly Source Type: blogs
AbstractPurpose of the ReviewThe goals of this review are to evaluate recent studies regarding comorbidity between migraine and different metabolic and endocrine disorders and to discuss the role of insulin resistance as a common pathogenetic mechanism of these diseases.Recent FindingsRecently, several studies showed that migraine is associated with insulin resistance, a condition in which a normal amount of insulin induces a suboptimal physiological response. All the clinical studies that used the oral glucose tolerance test to examine insulin sensitivity found that, after glucose load, there is in migraine patients a sig...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
A 62-year-old tall, thin African American man presented to the emergency department after four days of constipation and vomiting. He had decreased mental status, and was unable to provide a complete medical background. His spouse reported that the patient had diffuse abdominal pain for the past four days, and had been experiencing increased thirst and excessive urination for the past four weeks.She reported that the patient was unresponsive to over-the-counter laxatives and had been unable to produce bowel movements. The patient had no prior abdominal surgery, medication use, or primary care visits. The patient used to be ...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
More News: Anesthesia | Anesthesiology | Bone Marrow Aspiration and Biopsy | Diabetes | Eating Disorders & Weight Management | Endocrinology | Hypothyroidism | Obesity | Orthopaedics | Pain | Ultrasound