Peripheral blood age-sensitive immune markers in multiple sclerosis: relation to sex, cytomegalovirus status, and treatment.

Background: Immunosenescence is accelerated by chronic infectious and autoimmune diseases and could contribute to the pathobiology of multiple sclerosis (MS). How MS and disease-modifying therapies (DMTs) impact age-sensitive immune biomarkers is only partially understood.

Methods: We analyzed 771 serum samples from 147 healthy controls and 289 people with MS (PwMS) by multiplex immunoassays.

GM-CSF distinctly impacts human monocytes and macrophages via ERK1/2-dependent pathways.

Human monocytes and macrophages are two major myeloid cell subsets with similar and distinct functions in tissue homeostasis and immune responses. GM-CSF plays a fundamental role in myeloid cell differentiation and activation. Hence, we compared the effects of GM-CSF on the expression of several immune mediators by human monocytes and monocyte-derived macrophages obtained from healthy donors.

Spatiotemporal dynamics of 5-HT receptor ciliary localization during mouse brain development.

The serotonin 5-HT receptor (5-HTR) is a promising target to improve cognitive symptoms of psychiatric diseases of neurodevelopmental origin, such as autism spectrum disorders and schizophrenia. However, its expression and localization at different stages of brain development remain largely unknown, due to the lack of specific antibodies to detect endogenous 5-HTR. Here, we used transgenic mice expressing a GFP-tagged 5-HTR under the control of its endogenous promoter (Knock-in) as well as embryonic stem cells expressing the GFP-tagged receptor to extensively characterize its expression at cellular and subcellular levels during development.

Relationship Between Mental Health and the Education Level in Elderly People: Mediation of Leisure Attitude.

Purpose: The present study intends to explore the influence of education on the mental health of retired people and the mediating role of a leisure attitude in this relationship.

Design/methodology: The sample was simple random, and a confidentiality agreement was established. The sample was composed of 403 Portuguese participants (37.

A regional massive hemorrhage protocol developed through a modified Delphi technique.

Background: A massive hemorrhage protocol (MHP) enables rapid delivery of blood components in a patient who is exsanguinating pending definitive hemorrhage control, but there is variability in MHP implementation rates, content and compliance owing to challenges presented by infrequent activation, variable team performance and patient acuity. The goal of this project was to identify the key evidence-based principles and quality indicators required to develop a standardized regional MHP.

Methods: A modified Delphi consensus technique was performed in the spring and summer of 2018.

Massive hemorrhage protocol activation in obstetrics: a 5-year quality performance review.

Background: A structured approach to hemorrhagic emergencies in obstetrics has gained popularity with the implementation of massive hemorrhage protocols. The trauma literature suggests that routine quality reviews should be in place to improve patient outcomes. The aim of this study was to develop quality indicators and assess compliance by the clinical team.

[What does the Internet teach the obstetric patient about labor analgesia?].

Background And Objectives: It has been observed a general public increased search on the Internet for health information, including Anesthesiology. The objective of this study was to evaluate the information available to the lay person in Portuguese on the Internet about labor analgesia for the Brazilian population.

Method: Using the term “labor anesthesia”, the first 20 sites found on Google in November 2014 were evaluated by two resident physicians and classified as medical and non-medical.

Preoperative celecoxib in noncardiac surgery: A systematic review and meta-analysis of randomised controlled trials.

Background: Postoperative pain continues to be undertreated after noncardiac surgery. Preoperative analgesic administration may enhance postoperative analgesia.

Objective: To determine the effects of preoperative administration of celecoxib in noncardiac surgery on pain and postoperative outcomes.

Spinal ultrasound versus palpation for epidural catheter insertion in labour: A randomised controlled trial.

Background: Ultrasound imaging of the spine is thought to reduce failed and traumatic neuraxial procedures. Most of the evidence supporting this assumption has been produced in the context of an expert sonographer performing the ultrasound assessment, and it remains unknown whether this technique is useful when used by multiple individual operators.

Objective: To invesstigate the impact of preprocedural spinal ultrasound on the ease of insertion of labour epidurals by a group of trainees.

[Microbial contamination of cuffs lab coats during health care].

The study aimed to evaluate the bacterial contamination in lab coats worn by nursing students, before and after being worn in health care practices. A quantitative and descriptive study was carried out, in which the students' coats were collected, washed and ironed in a standardized way and wore for four hours in assistance activities. Subsequently, samples from the cuffs were collected with sterile cotton swabs in order to be incubated in order to analyze microbial growth through morphological analysis by Gram's Method and antibiogram.

A scoping review of the evidence for teaching ultrasound-guided regional anesthesia.

A scoping review was performed to assess published evidence regarding how best to teach ultrasound-guided regional anesthesia (UGRA). The literature search yielded 205 articles, of which 35 met the inclusion criteria. Current literature on the topic can be divided into 3 main themes: the development of motor skills, learning and teaching sonoanatomy, and understanding of the requirements for establishing a UGRA education program and evaluation.

The epidural electric stimulation test does not predict local anesthetic spread or consumption in labour epidural analgesia.

Purpose: The epidural electrical stimulation test (EEST) is a highly specific and sensitive test for confirming placement of the epidural catheter in the epidural space. The purpose of this study was to investigate if the EEST could predict the spread and consumption of local anesthetic solutions during labour epidural analgesia.

Methods: This observational study was conducted in labouring parturients requesting epidural analgesia.

Case report: Rhabdomyolysis in morbidly obese patients: anesthetic considerations.

Purpose: We report the presentation and management of rhabdomyolysis involving shoulder girdle and upper arm muscles in a morbidly obese patient after prolonged laparoscopic surgery.

Clinical Features: A 41-yr-old morbidly obese woman presented for laparoscopic abdominal hysterectomy. She had hypertension and type II diabetes which were controlled on regular medications.

Transversus abdominis plane block for postoperative analgesia after Caesarean delivery performed under spinal anaesthesia? A systematic review and meta-analysis.

The transversus abdominis plane (TAP) block is a field block that provides postoperative analgesia for abdominal surgery. Its analgesic utility after Caesarean delivery (CD) remains controversial. This systematic review and meta-analysis examines whether TAP block can reduce i.

Epidural anesthesia for Cesarean delivery in a patient with post-traumatic cervical syringomyelia.

Purpose: To illustrate the successful management of a patient with post-traumatic syringomyelia (PTS) and chronic pain syndrome who presented for elective Cesarean delivery under epidural anesthesia.

Clinical Findings: A 30-yr-old gravida 3 para 1 woman, with a known diagnosis of cervical PTS secondary to a whiplash injury sustained three years earlier, presented to the labour and delivery unit at 31 weeks' gestation. She had severe pain in the cervical and lumbar spine, motor and sensory deficits in the upper extremities, tender mass in her left trapezius muscle, and history of dizziness and syncopal episodes.

The intercristal line determined by palpation is not a reliable anatomical landmark for neuraxial anesthesia.

Purpose: The radiological intercristal line (Tuffier's line) usually intersects the spine at the L4-L5 interspace. The intercristal line determined by palpation may be used erroneously as a surrogate for the true radiological Tuffier's line. We studied term pregnant women to establish the level at which a transverse line connecting the superior aspects of the iliac crests, as determined by palpation, intersects the lumbar spine, as assessed by ultrasound.

Anesthesiologists' learning curves for ultrasound assessment of the lumbar spine.

Background And Objectives: Ultrasound assessment of the lumbar spine to facilitate neuraxial anesthesia has recently received much attention. The transfer of knowledge pertaining to this skill has never been studied. The purpose of this study was to determine the amount of teaching needed to achieve competence in spinal ultrasound.

Simulation of ultrasound-guided peripheral nerve block: learning curve of CET-SMA/HSL Anesthesiology residents.

Background And Objectives: The use of ultrasound imaging in peripheral nerve block has been increasing. However, there are few reports in the literature on the learning curve of the ultrasound technique. The objective of this report was to evaluate the learning curve of CET-SMA/HSL Anesthesiology residents of ultrasound-guided peripheral block using an experimental agar model.

The intraoperative use of warming blankets in patients undergoing radical prostatectomy is related with a reduction in post-anesthetic recovery time.

Background And Objectives: Anesthesia and the surgeries cause substantial thermal changes, and hypothermia can lead to cardiovascular complications, clotting disorders, immunologic changes, and disruption of water and electrolyte balances, besides decreasing drug metabolism and, therefore, increasing post-anesthetic recovery time (PART). Circulation of warm air (forced-air warming blanket) is the most effective non-invasive warming method currently available. The objective of the present study was to compare the time spent in the recovery room of patients undergoing radical prostatectomy with and without the intraoperative use of a forced-air warming blanket.

Hemodynamic effects of PEEP in a porcine model of HCl-induced mild acute lung injury.

Background: Positive end-expiratory pressure (PEEP) and sustained inspiratory insufflations (SI) during acute lung injury (ALI) are suggested to improve oxygenation and respiratory mechanics. We aimed to investigate the hemodynamic effects of PEEP with and without alveolar recruiting maneuver in a mild ALI model induced by inhalation of hydrochloric acid.

Methods: Thirty-two pigs were randomly allocated into four groups (Control-PEEP, Control-SI, ALI-PEEP and ALI-SI).

Pulmonary function is better preserved in pigs when acute normovolemic hemodilution is achieved with hydroxyethyl starch versus lactated Ringer's solution.

Acute normovolemic hemodilution (ANH) has been proposed to decrease the need for allogenic blood transfusion. Consequently, great amounts of fluids are necessary to maintain hemodynamics during and after blood removal. The aim of this experiment was to evaluate the oxygenation, respiratory compliance, and lung structure during ANH performed with lactated Ringer's solution and hydroxyethyl starch (HES).

Hydroxyethyl starch is superior to lactated Ringer as a replacement fluid in a pig model of acute normovolaemic haemodilution.

Background: Tissue tolerance to oxygen privation during acute normovolaemic haemodilution with different fluids remains unclear. We tested the hypothesis that hydroxyethyl starch (HES) is superior to lactated Ringer's solution in pigs for preserving tissue perfusion during acute normovolaemic haemodilution.

Methods: Twenty-four animals were randomized into control, lactated Ringer's solution and HES groups.