Delayed primary flexor tendon repair in zone II injuries: results of using WALANT and controlled true active motion.

Early repair of flexor tendon injuries is ideal, but delays are common. We studied the outcomes of flexor tendon repairs delayed from 5 days to 6 months and carried out under wide-awake local anaesthesia with no tourniquet (WALANT). Twenty-four patients (29 fingers) who underwent primary flexor tendon repair on zone II using a four- to six-strand core suture technique, followed by controlled early active motion therapy.

Penehyclidine for postoperative nausea and vomiting in patients receiving general anesthesia: A systematic review and meta-analysis protocol.

Background: Postoperative nausea and vomiting (PONV) is a common complication of general anesthesia. This affects 30-80% of patients, and leads to discomfort and extended hospital stays. The effectiveness of penehyclidine for preventing PONV remains a subject of debate in the literature.

Tailoring anaesthetic strategies for diabetes research: Acepromazine vs. medetomidine in Aachen minipigs.

Pre-established anaesthetic protocols in animal models might unexpectedly interfere with the main outcome of scientific projects and therefore they need to account for the specific research goals. We aimed to optimize the anaesthetic protocol and animal handling strategies in a diabetes-related-study exemplifying how the anaesthetic approach must be adjusted for individual research targets. Aachen minipigs were used as a model to test long-lasting skin glucose sensors for diabetic human patients.

Feasibility of rabbit auricular VX2 tumor model as an experimental model for intra-arterial embolization.

This study aimed to evaluate the feasibility of VX2 tumor in rabbit auricles as an experimental model for intra-arterial embolization. This study was approved by our Institutional Animal Care and Use Committee. VX2 tumors were implanted in both auricles of 12 New Zealand White Rabbits.

Comparison of two active warming techniques on body temperature in healthy, anesthetized dogs premedicated with acepromazine or dexmedetomidine: A pilot study.

Temperature regulation in dogs is significantly impaired during general anesthesia. Glabrous skin on paws may facilitate thermoregulation from this area and is a potential target for interventions attenuating hypothermia. This pilot study aimed to compare efficacy of an innovative warming device placed on the front paws (AVAcore; AVA), with no warming methods (NONE) and conventional truncal warming methods (CONV; circulating water blanket/forced air warmer) on rectal temperature and anesthetic recovery times.

Cost of lung cancer diagnosis: cost differences between national health system and private sector.

Lung cancer is still diagnosed at an advanced stage due to lack of early disease symptoms. We have techniques and equipment for rapid on site evaluation of pulmonary lesions. However, with new technology or a combination of technologies in the diagnostic suite the cost of biopsy is rising.

The Efficacy of Cryoneurolysis on Chronic Pain in Patients with Knee Osteoarthritis; A Double-blinded Randomized Controlled Sham Trial.

Background: The objective was to investigate if cryoneurolysis were superior to sham in reducing pain intensity in patients with chronic knee osteoarthritis. We hypothesized that cryoneurolysis was an effective and safe therapy to reduce chronic pain in patients with knee osteoarthritis.

Methods: The study was a randomized, double-blind, sham-controlled.

An Intrathecal Pump Misadventure in Two Acts: An Unrecognized Partial Pocket Fill Followed by an Unusual Withdrawal Syndrome Two Months Later.

We present a case of a patient with an intrathecal pump who experienced an unrecognized partial pocket fill, leading to an atypical opioid withdrawal characterized by akathisia. A 57-year-old female with multiple myeloma presented to an emergency department with new-onset akathisia requiring admission. Eight weeks prior, her intrathecal pump was refilled with morphine, bupivacaine, and ziconotide.

Accuracy of two-compartment modelling of gas exchange with ventilation-perfusion mismatch in inhalational anesthesia.

Background: Multi-compartment computer models of heterogeneity in alveolar ventilation-perfusion ratios (VA/Q scatter) across the lung explain the significant alveolar-arterial (A-a) partial pressure gradients and associated alveolar dead-space fractions (VDA/VA) seen in anesthetized patients for both carbon dioxide and for anesthetic gases of different blood solubilities. However, the accuracy of a simpler two-compartment model of VA/Q scatter to do this has not been tested or compared to calculations from the traditional Riley model with "ideal", unventilated (shunt) and unperfused (deadspace) compartments.

Methods: Measurements of gas partial pressures in inspired and expired gas and arterial and mixed venous blood from 29 patients undergoing inhalational general anesthesia for cardiac surgery was used to compare the accuracy of two simple models of VA/Q scatter and lung gas exchange in predicting measured alveolar and arterial partial pressure differences, and associated alveolar dead-space calculations for the modern anesthetic gases isoflurane, sevoflurane and desflurane.

Enhanced patient recovery with early extensive surgical deb-ridement in Fournier's Gangrene: evaluation of perioperative outcomes in a multicentric experience.

Objective: Fournier's gangrene (FG) is a rare, life-threatening necrotizing fasciitis primarily affecting the perineal, genital, and perianal regions. This rapidly progressing bacterial infection predominantly affects middleaged and elderly men. This multicenter study aims to describe the management in a wide cohort of Fournier's gangrene cases that presented to three tertiary centers with early extensive surgical debridement.

Evaluation of Eye Alignment Before and After Refractive Surgery Using an Implantable Collamer Lens in Phakic Patients with Myopia.

Purpose: To investigate changes in eye alignment before and after ICL implantation in patients with myopia having corrected distance visual acuity (CDVA) of ≥0.0 logMAR.

Subjects And Methods: The medical records of 1012 patients without eye movement limitation who underwent bilateral ICL implantation were retrospectively reviewed a at the Eye Center of Sanno Hospital in Japan.

Safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia: A systematic review.

Objective: The objective of this study was to analyze available evidence on efficacy and safety of sugammadex in reversing neuromuscular blockades in patients with Myasthenia Gravis (MG), thereby providing a comprehensive understanding of its potential benefits and risks in this specific patient population.

Methods: We performed a systematic search for studies from PubMed, Embase, Web of Science, and Google Scholar. Sources were screened using Rayyan, following predefined inclusion and exclusion criteria focusing on English articles published from 2010 to 2024 on MG patients under general anesthesia.

Practicing Emotional Self-awareness to Build Surgeon Resilience.

As surgeons, we work in a high-stress, high-stakes environment to take care of our patients. In this setting, it is not uncommon for us to experience microaggressions-subtle or indirect actions or statements that communicate a demeaning or exclusionary message, often unintentionally. Microaggressions can bring us down, taking away from the fulfillment that attracted many of us to this profession.

Nutrition users' guides: systematic reviews part 1 -structured guide for methodological assessment, interpretation and application of systematic reviews and meta-analyses of non-randomised nutritional epidemiology studies.

Due to the challenges of conducting randomised controlled trials (randomised trials) of dietary interventions, evidence in nutrition often comes from non-randomised (observational) studies of nutritional exposures-called nutritional epidemiology studies. When using systematic reviews of such studies to advise patients or populations on optimal dietary habits, users of the evidence (eg, healthcare professionals such as clinicians, health service and policy workers) should first evaluate the rigour (validity) and utility (applicability) of the systematic review. Issues in making this judgement include whether the review addressed a sensible question; included an exhaustive literature search; was scrupulous in the selection of studies and the collection of data; and presented results in a useful manner.

Nutrition users' guides: RCTs part 1 - structured guide for assessing risk of bias in randomised controlled trials that address therapy or prevention questions.

The purpose of this article, part 1 of 2 on randomised controlled trials (RCTs), is to provide readers (eg, clinicians, patients, health service and policy decision-makers) of the nutrition literature structured guidance on interpreting RCTs. Evaluation of a given RCT involves several considerations, including the potential for risk of bias, the assessment of estimates of effect and their corresponding precision, and the applicability of the evidence to one's patient. Risk of bias refers to flaws in the design or conduct of a study that may lead to a deviation from measuring the underlying true effect of an intervention.

Enhancing Perinatal Safety with the Advancement of Obstetric Anesthesia in Japan.

Japan is one of the most developed countries in the world, and perinatal care is safe, with low maternal and neonatal mortality rates. However, as birthrate declines, advanced maternal age and the number of cesarean deliveries increases, efforts must be made to maintain safety in the future. The characteristic of the delivery facilities is "many small clinics," and half of all facilities have fewer than 500 deliveries per year.

Surgical management of benign tumors of the parotid gland: the advantages of extracapsular dissection compared to traditional surgical techniques.

Introduction: Salivary gland tumors represent only 3%-6% of all head and neck neoplasms, and approximately 70% of these tumors are located in the parotid gland. Most of these tumors are found in the more abundant superficial portion of the parotid gland, lateral to the facial nerve (FN). For many years, the location of the facial nerve between the superficial and deep segments of the parotid gland hindered adequate tumor extirpation.

Using Bayesian Hypothesis-testing to Reanalyze Randomized Controlled Trials: Does it Always Tell the Truth, the Whole Truth and Nothing but the Truth?

Unlabelled: Adequately powered randomized controlled trials (RCTs) are considered the highest level of evidence in guiding clinical practice. Reports using Bayesian hypothesis-testing to reanalyze RCTs are increasing. One distinct advantage of Bayesian analysis is that we can obtain a range of numerical probabilities that reflect how likely a study intervention is more effective than the alternative after considering both pre-existing available evidence and the alternate hypotheses.

Echoes and Shadows: Predicting Hepatorenal Syndrome Outcomes with Lung Ultrasound and X-rays.

Kothekar AT, Shah KB. Echoes and Shadows: Predicting Hepatorenal Syndrome Outcomes with Lung Ultrasound and X-rays. Indian J Crit Care Med 2024;28(11):993-994.