Role of Metals on SARS-CoV-2 Infection: a Review of Recent Epidemiological Studies.

Purpose Of Review: Metals and metalloids are known for their nutritional as well as toxic effects in humans. In the context of the SARS-CoV-2 pandemic, understanding the role of metals on COVID-19 infection is becoming important due to their role in infectious diseases. During the past 2 years, a significant number of studies have examined the impact of metals and metalloids on COVID-19 morbidity and mortality.

An Artificial Intelligence-Based Smartphone App for Assessing the Risk of Opioid Misuse in Working Populations Using Synthetic Data: Pilot Development Study.

Background: Opioid use disorder (OUD) is an addiction crisis in the United States. As recent as 2019, more than 10 million people have misused or abused prescription opioids, making OUD one of the leading causes of accidental death in the United States. Workforces that are physically demanding and laborious in the transportation, construction and extraction, and health care industries are prime targets for OUD due to high-risk occupational activities.

Hot topics in liver intensive care.

Liver dysfunction is an independent predictor of mortality among intensive care patients. Avoidance or early restoration of normal liver function should therefore be targeted in all critically ill patients. The present work seeks to provide an overview of the "hottest topics" among liver-related problems in intensive care.

Femoral nerve blockade administered preclinically for pain relief in severe knee trauma is more feasible and effective than intravenous metamizole: a randomized controlled trial.

Background: Before clinical treatment and during transportation, the analgesic therapy offered to patients with painful knee trauma may be quite insufficient. We hypothesize that a femoral nerve blockade for analgesia can be administered in a preclinical setting at the injury site and provides better pain relief than intravenous metamizole, whose analgesic effect is comparable with that of opioids.

Methods: After an initial clinical investigation, 52 patients were randomized according to computer-generated codes; 26 patients received a femoral nerve blockade and 26 received metamizole.

Molecular weight of hydroxyethyl starch molecules influences coagulation profile measured by thrombelastography.

Background: The consensus about the ideal intravenous fluid in trauma patients remains open. However, hypertonic saline and hydroxyethyl starch (HES) seems to have advantages in terms of immuno-modulatory and haemodynamic effects. Nevertheless clotting abnormalities are frequently reported in association with the use of HES.

A randomized controlled trial of femoral nerve blockade administered preclinically for pain relief in femoral trauma.

Background: Analgesia at the location of the accident and on transport for femoral trauma is often delayed or insufficient. In this prospective, randomized, controlled study, we evaluated the preclinical use of femoral nerve blockade for reducing pain and anxiety compared with IV analgesia using metamizol.

Methods: Patients with painful femoral trauma, such as fracture or severe contusion, were randomized to receive at the site of the accident a femoral nerve blockade (n = 31) or IV analgesia with metamizol (n = 31).

[The use of oxygen as drug and its relevance for wound healing].

Plastic surgeons often have to deal with problematic wounds. In reconstructive surgery, as well as in chronic wounds, tissue oxygen supply is often critically low. Similarly in the treatment of severely burned patients, perfusion and oxygen supply to the areas beneath burn wounds are often critical.

Base deficit and lactate: early predictors of morbidity and mortality in patients with burns.

Severe burn results in severe and unique physiological changes called burn shock. Historically, resuscitation has been guided by a combination of basic laboratory values, invasive monitoring and clinical findings, but the optimal guide to the endpoint of resuscitation still remains controversial. Two hundred and eighty patients, who were admitted to our Burn Unit, were enrolled in this prospective study.

The influence of stellate ganglion transcutaneous electrical nerve stimulation on signal quality of pulse oximetry in prehospital trauma care.

Background: Accurate monitoring of the peripheral arterial oxygen saturation has become an important tool in the prehospital emergency medicine. This monitoring requires an adequate plethysmographic pulsation. Signal quality is diminished by cold ambient temperature due to vasoconstriction.

Antithrombin deficiency and its relationship to severe burns.

Antithrombin (AT) is an important endogenous anticoagulant and exhibits marked anti-inflammatory properties. To evaluate the incidence of AT deficiency in severe burn and its correlation to the variables of the abbreviated burn severity index (ABSI), length of hospital stay (LOS) and mortality we collected data on the substitution of human plasma-derived AT concentrate in 201 consecutive patients suffering from severe burn. One hundred and eight patients (54%) developed AT deficiency during their hospitalisation and, according to our institutional practice, received substitution therapy by continuous infusion to maintain physiological plasma activity (70-120%).

Postanaesthetic considerations and complications after ambulatory anaesthesia.

Ambulatory or day-case surgery is being employed to an ever-increasing extent. Although it has many advantages, it is not suited to the needs of every patient. For example, patients who live alone, particularly the elderly, might well not be able to care for themselves adequately after such surgery and are probably at a higher risk of developing complications, including infections.

Dynamic CT measurement of pulmonary enhancement in piglets with experimental acute respiratory distress syndrome.

Purpose: To investigate whether analysis of a washout curve of contrast material obtained with serial computed tomography (CT) enables differentiation between hydrostatic pulmonary edema and pulmonary edema caused by increased capillary permeability.

Materials And Methods: The institutional committee on animal experiments approved this study, which was performed in accordance with designated guidelines. Chest CT was performed in 12 piglets after induction of anesthesia and start of mechanical ventilation.

Transcutaneous electrical nerve stimulation as prehospital emergency interventional care: treating acute pelvic pain in young women.

Objectives.  In Europe, patients with acute pelvic pain are transported to the hospital in an ambulance without an emergency physician. We hypothesized that transcutaneous electrical nerve stimulation (TENS) would be an effective noninvasive procedure for pain treatment.

Effect of newer anaesthetics on duration of stay in postanaesthesia care unit in patients undergoing major abdominal surgery.

Newer anaesthetic agents, such as remifentanil and sevoflurane, are more expensive than conventional anaesthetics, such as isoflurane and fentanyl. However, newer anaesthetics might outweigh their higher acquisition costs by reducing length of stay in the postanaesthesia care unit and thereby reducing personnel costs. We retrospectively investigated the influence of newer anaesthetics on time to eligibility for discharge from the postanaesthesia care unit in consecutive patients undergoing major abdominal surgery.

Clonidine as an adjuvant to local anaesthetic axillary brachial plexus block: a randomized, controlled study.

Background: We compared the effects of clonidine added to levobupivacaine and bupivacaine on axillary brachial plexus block as well as the effectiveness of levobupivacaine alone compared with bupivacaine alone.

Methods: In this prospective, randomized, controlled, double-blind trial, four groups of 20 patients each were investigated, using (i) 40 ml of levobupivacaine 0.5% plus 0.

Heparinase-modified thrombelastography in term and preterm neonates.

Unlabelled: Thrombelastography (TEG) appears to be a promising test to assess coagulation in infants and children. TEG enables a rapid assessment of hemostatic function with only 300 microL of whole blood and provides information about plasmatic coagulation, platelet function, and fibrinolysis. In this study, we used TEG to assess the coagulation system of preterm and term neonates to determine the effects of their deficient coagulation factor levels on global hemostatic function.

Acetylsalicylic acid, diclofenac, and lornoxicam, but not rofecoxib, affect platelet CD 62 expression.

Unlabelled: Nonsteroidal antiinflammatory drugs are routinely administered in the perioperative period. Because of the absence of cyclooxygenase-2 in platelets, cyclooxygenase-2-selective drugs are thought not to cause platelet inhibition. Because platelets play an important role in the coagulation process, the absence of platelet function inhibition may lead to fewer bleeding complications after surgery.

The influence of VIP and epoprostenol on platelet CD62P expression and primary haemostasis in vitro.

Human vasoactive intestinal peptide (VIP) and epoprostenol (prostacyclin) have vasodilatative effects in the pulmonary circulation. Both VIP and epoprostenol are successfully used to treat pulmonary hypertension in humans and experimental animal models. The positive effects of epoprostenol on the course of this disease are achieved through vasodilatation and inhibitory effects on platelet activity.

Educational or organizational approach: which is more effective in changing blood-sampling habits?

Unlabelled: Diagnostic blood loss is a recognized issue during the delivery of intensive care services. We designed this study to compare the effects of educational versus organizational approaches to reduce daily diagnostic blood loss in intensive care patients. First, as an educational approach, physicians on two wards were repeatedly informed about the importance of diagnostic blood loss and that 1.

Awake nasotracheal fiberoptic intubation: patient comfort, intubating conditions, and hemodynamic stability during conscious sedation with remifentanil.

Awake nasotracheal fiberoptic intubation requires an anesthetic management that provides sufficient patient comfort, adequate intubating conditions, and stable hemodynamics. Short-acting and easily titratable analgesics are excellent choices for this maneuver. In this study, our aim was to determine an appropriate dosage regimen of remifentanil for awake nasotracheal fiberoptic intubation.

Onset time, quality of blockade, and duration of three-in-one blocks with levobupivacaine and bupivacaine.

Levobupivacaine is the isolated S(-)-stereoisomer of racemic bupivacaine. Important pharmacodynamic properties of levobupivacaine have not been determined for the femoral three-in-one block. In this randomized, controlled, double-blinded trial, we studied 60 ASA physical status I-III patients scheduled for surgery of the lower limb.

Nutrition and anabolic agents in burned patients.

Purpose Of Review: Much of the morbidity and mortality of severely burned patients is connected with hypermetabolism and catabolism with its accompanying impairment of wound healing and increased infection risks. In order to prevent the erosion of body mass, nutritional support and other strategies to prevent catabolism have become a major focus in the care of severely burned patients.

Recent Findings: Major themes discussed in recent literature are dealing with enteral versus parenteral nutrition and gastric versus duodenal feeding.

The effect of graded hypothermia (36 degrees C-32 degrees C) on hemostasis in anesthetized patients without surgical trauma.

Unlabelled: The isolated effects of hypothermia on hemostasis have not been investigated in healthy humans. We cooled 16 anesthetized patients scheduled for elective intracranial surgery to 32 degrees C body core temperature and assessed prothrombin time (PT), activated partial thromboplastin time, thrombelastogram (TEG), closure time, and platelet count at 36 degrees C, 34 degrees C, and 32 degrees C body core temperature after the induction of anesthesia but before surgical intervention. Activated partial thromboplastin time, hematocrit, and closure time did not change, whereas PT and platelet count decreased during cooling.