Citations

Significance Our data demonstrate that differences in host genotype that affect the carbohydrate landscape of the distal gut interact with diet to alter the composition and function of resident microbes in a diet-dependent manner.

AbstractPurposeThe purpose of this study was to evaluate the utility of multimodal analgesia with fascia iliaca blockade and for acute pain control in patients undergoing hip arthroscopy.MethodsThirty consecutive patients undergoing primary hip arthroscopy were prospectively studied. All patients were treated preoperatively with ultrasound‐guided single injection fascia iliaca blockade and multimodal analgesia. Data collected included post‐operative nausea, numeric rating scale (NRS) pain scores during rest and activity, opioid consumption during the first five days (recorded as tablets of 5 mg hydrocodone/500 mg acetaminophen) and overall patient satisfaction with analgesia.ResultsThis study included 23 female and 7 male patients with a median age of 35 years (range 14–58). No patient required medication for post‐operative nausea. The overall NRS scores were an average of 3.9 on day 0, 3.6 on day 1, 3.4 on day 2, 2.9 on day 3, 3.0 on day 4 and 2.7 on day 5. The average tablets of opioid taken were 1.5 on day 0, 1.2 on day 1, 1.3 on day 2, 1.0 on day 3, 1.1 on day 4 and 0.9 on day 5. Overall, 20 patients rated their post‐operative pain control as very satisfied (67 %), and 10 patients as satisfied (33 %). There were no complications or side effects from the fascia iliaca blockade.ConclusionIn this prospective study, multimodal analgesia with fascia iliaca blockade following hip arthroscopy was safe and effective. The quality of early post‐operative analgesia provided by the fascia iliaca blockade was excellent and resulted in low opioid consumption, high quality of pain relief and high overall patient satisfaction.Level of evidenceProspective case series, Level II.

We determined whether a non-invasive gas exchange based estimate of pulmonary vascular (PV) capacitance [PV CAP = stroke volume (SV) x pulmonary arterial pressure (Ppa)] (GX CAP ) tracked the PV response to exercise in heart-failure (HF) patients. Pulmonary wedge pressure (Ppw), Ppa, PV resistance (PVR), and gas exchange were measured simultaneously during cycle exercise in 42 HF patients undergoing right-heart catheterization. During exercise, P ET CO 2 and V E /VCO 2 were related to each other ( r= -0.93, P < 0.01) and similarly related to mean Ppa (mPpa) ( r = -0.39 and 0.36; P < 0.05); P ET CO 2 was subsequently used as a metric of mPpa. Oxygen pulse (O 2 pulse) tracked the SV response to exercise (r = 0.91, P < 0.01). Thus, GX CAP was calculated as O 2 pulse x P ET CO 2 . During exercise, invasively determined PV CAP and non-invasive GX CAP were related (r = 0.86, P < 0.01), and GX CAP correlated with mPpa and PVR (r = -0.46 and -0.54; P < 0.01). In conclusion, noninvasive gas exchange measures may represent a simple way to track the PV response to exercise in HF.