Multimodal analgesia with parasternal plane block protocol within an enhanced recovery after cardiac surgery program decreases opioid use.

Objective: This study investigated the efficacy of a multimodal analgesia (MMA) with an opioid-sparing strategy, incorporating a parasternal plane block (PPB) within a systematic standardized Enhanced Recovery After Surgery (ERAS) program for patients undergoing elective cardiac surgery.

Methods: From 2015 to 2021, 3153 patients underwent elective coronary artery bypass grafting and/or valve procedures. Patients were dichotomized by the presence or absence of an ERAS program including a perioperative MMA with an opioid-sparing approach and PPB protocols.

Infection with Toxoplasma gondii triggers coagulation at the blood-brain barrier and a reduction in cerebral blood flow.

Background: Immunothrombosis is the process by which the coagulation cascade interacts with the innate immune system to control infection. However, the formation of clots within the brain vasculature can be detrimental to the host. Recent work has demonstrated that Toxoplasma gondii infects and lyses central nervous system (CNS) endothelial cells that form the blood-brain barrier (BBB).

Worse survival of hepatocellular cancer patients with membranous insulin receptor overexpression.

Hepatocellular cancer (HCC) therapy is in need for an ideal companion diagnostic. Preclinical experimental studies have identified the insulin receptor (IR) and its synergistic counterpart, the IGF1 receptor (IGF1R), as relevant in HCC development, and the ligands IGF1 and IGF2 have been found to be elevated in HCC. This study aimed to bridge the gap to the clinical setting and explore whether the IR or the IGF1R would be of prognostic significance and would be associated with clinicopathologic parameters in HCC patients.

Finding predictive factors of exercise adherence in randomized controlled trials on low back pain: an individual data re-analysis using machine learning techniques.

Objective: To identify predictors of adherence in supervised and self-administered exercise interventions for individuals with low back pain.

Design: Cohort study.

Setting: Rehabilitation.