A systematic review and meta-analysis of efficacy of vasopressin as a vasoconstrictive and uterotonic drug in laparoscopic myomectomy.

Introduction: Laparoscopic myomectomy is a commonly performed operation with fast recovery and excellent results. However, haemorrhagic nature of the operation mandates us to use variety of vasoconstrictive and uterotonic agents. Amongst which, one of them is vasopressin.

Efficacy of oral modafinil on accelerating consciousness recovery in adult patients with moderate to severe acute traumatic brain injury admitted to intensive care unit: a randomized double-blind clinical trial.

Background: Traumatic Brain Injury (TBI) is a leading cause of hospitalization and disability in young and middle-aged adults. This study aims to survey the efficacy of oral modafinil, a low-side-effect central nervous system stimulant, in the enhancement of consciousness recovery in moderate to severe TBI patients in the ICUs of a referral trauma center.

Materials And Methods: All ICU patients meeting inclusion criteria between April 2021 and April 2023 were screened.

Intestinal oxygen utilisation and cellular adaptation during intestinal ischaemia-reperfusion injury.

The gastrointestinal tract can be deranged by ailments including sepsis, trauma and haemorrhage. Ischaemic injury provokes a common constellation of microscopic and macroscopic changes that, together with the paradoxical exacerbation of cellular dysfunction and death following restoration of blood flow, are collectively known as ischaemia-reperfusion injury (IRI). Although much of the gastrointestinal tract is normally hypoxemic, intestinal IRI results when there is inadequate oxygen availability due to poor supply (pathological hypoxia) or abnormal tissue oxygen use and metabolism (dysoxia).

Comprehensive Analysis of Bulk RNA-Seq and Single-Cell RNA-Seq Data Unveils Sevoflurane-Induced Neurotoxicity Through SLC7A11-Associated Ferroptosis.

Sevoflurane's potential impact on cognitive function and neurodevelopment, especially in susceptible populations such as infants and the elderly, has raised widespread concern. This study focuses on how sevoflurane induces ferroptosis in astrocytes and identifies solute carrier family 7 member 11 (SLC7A11) as a mediator of ferroptosis, providing new insights into sevoflurane-related neurotoxic pathways. We analysed single-cell sequencing (scRNA-seq) data from sevoflurane-exposed mice and control mice, supplemented with bulk RNA-seq data, to assess gene expression alterations.

Comparative analysis of clinico-metabolic profiles between St Thomas and del Nido cardioplegia solutions: A pilot study.

Introduction: Cardioplegia (CP) is integral to myocardial protection during cardiac surgery. Two standard cardioplegic solutions viz. Del Nido solution (DNS) and St Thomas solution (STS) are widely used in cardiac surgeries.

Ultrasound-guided Genicular Nerve Block in Patients Undergoing Knee Arthroscopy: A Randomized Controlled Trial.

This study was to investigate the efficacy of ultrasound-guided genicular nerve block for patients who underwent knee arthroscopy. Patients were randomized into two groups: 1. nerve block group: ultrasound-guided genicular nerve block (superomedial, superolateral and inferomedial genicular nerve, 2-ml 0.

Impact of a personalized intervention on preoperative anxiety and determination of the minimal clinically important difference in anxiety levels - a randomized clinical trial.

Background: Preoperative anxiety is common and most patients experiencing preoperative anxiety would welcome support to cope with their anxiety. Studies examining the effectiveness of information to reduce anxiety have been inconsistent. In addition, it is unclear whether results reported to be statistically significant are also clinically relevant.

Covert perioperative strokes in older patients having non-cardiac surgery (PRECISION): a prospective cohort analysis.

Background: Perioperative strokes may promote postoperative neurocognitive dysfunction. We thus evaluated the incidence of postoperative strokes and the association between strokes and postoperative neurocognitive outcomes in older patients recovering from non-cardiac surgery.

Methods: PRECISION was a two-center prospective cohort study.

Ultrasound-Guided Percutaneous Cryoneurolysis for the Treatment of Pain following Traumatic Rib Fracture: A Randomized, Active-Controlled, Participant- and Observer-Masked Study.

Background: Traumatic rib fractures are associated with pain lasting weeks to months and a decreased ability to inspire deeply or cough to clear secretions. Ultrasound-guided percutaneous cryoneurolysis involves reversibly ablating peripheral nerve(s) using exceptionally low temperature with a transdermal probe, resulting in a prolonged nerve block with a duration measured in months. We hypothesized that cryoneurolysis would improve analgesia and inspired volume following rib fracture.

Can the large language model ChatGPT-4omni predict outcomes in adult patients with status epilepticus?

Objective: Large language models (LLMs) have recently gained attention for clinical decision-making and diagnosis. This study evaluates the performance of the recently updated LLM (ChatGPT-4o) in predicting clinical outcomes in patients with status epilepticus and compares its prognostic performance to the Status Epilepticus Severity Score (STESS).

Methods: This retrospective single-center cohort study was performed at the University Hospital Basel (tertiary academic medical center) from January 2005 to December 2022.

A Comparison of Environmental Impacts Between Reusable and Disposable Flexible Laryngoscopes.

Introduction: There is increasing prevalence of single-use flexible laryngoscopes in Otolaryngology. This study aims to quantify and compare the environmental outcomes of single-use disposable flexible laryngoscopes (SUD-Ls) and reusable flexible laryngoscope (R-Ls).

Methods: The ISO 14040 standardized Life Cycle Assessment (LCAs) was utilized to estimate the environmental footprint of SUD-L and R-L.

Electroencephalography and Anesthetic Depth in Children Under 2 Years of Age: A Prospective Observational Study.

Background: Processed electroencephalogram (EEG) indices are widely used to monitor anesthetic depth. However, their reliability in children under 2 years of age remains questionable. During anesthesia maintenance in this age group, processed EEG indices frequently exhibit unexpectedly elevated values that exceed the intended target range.

Brain-Derived Exosomal miR-9-5p Induces Ferroptosis in Traumatic Brain Injury-Induced Acute Lung Injury by Targeting Scd1.

Aims: This study aimed to explore the role and underlying mechanisms of brain-derived exosomes in traumatic brain injury-induced acute lung injury (TBI-induced ALI), with a particular focus on the potential regulation of ferroptosis through miRNAs and Scd1.

Methods: To elucidate TBI-induced ALI, we used a TBI mouse model. Exosomes were isolated from the brains of these mice and characterized using TEM and NTA.

High Shear Stress Reduces ERG Causing Endothelial-Mesenchymal Transition and Pulmonary Arterial Hypertension.

Background: Computational modeling indicated that pathological high shear stress (HSS; 100 dyn/cm) is generated in pulmonary arteries (PAs; 100-500 µm) in congenital heart defects causing PA hypertension (PAH) and in idiopathic PAH with occlusive vascular remodeling. Endothelial-to-mesenchymal transition (EndMT) is a feature of PAH. We hypothesize that HSS induces EndMT, contributing to the initiation and progression of PAH.

Systematic Review and Meta-Analysis of Application of Ultrasound-Guided Thoracic Paravertebral Block in Clinical Surgical Treatment.

Aim: There is a lack of consensus regarding the efficacy of thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) for postoperative pain in randomized controlled trials (RCTs). The comparison of TPVB and ESPB was explored through a systematic review and meta-analysis (MA) of relevant RCTs.

Methods: A comprehensive search of relevant literature was conducted using databases such as PubMed, Embase, and MEDLINE, from 2019 to June 2024.

Drive Pressure-Guided Individualized Positive End-Expiratory Pressure in Traumatic Brain Injury Surgery: A Randomized Controlled Trial.

Aim: Intraoperative lung-protective ventilation strategies (LPVS) have been shown to improve lung oxygenation and prevent postoperative pulmonary problems in surgical patients. However, the application of positive end-expiratory pressure (PEEP)-based LPVS in emergency traumatic brain injury (TBI) has not been thoroughly explored. The purpose of this study is to evaluate the effects of drive pressure-guided individualized PEEP on perioperative pulmonary oxygenation, postoperative pulmonary complications, and recovery from neurological injury in patients with TBI.

Intraoperative Electroencephalogram Frontal Low Alpha Power for Predicting Postoperative Delirium in Elderly Patients after Orthopedic Surgery: A Prospective Cohort Study.

Aim: Postoperative delirium (POD) is a common complication with significant adverse effects in elderly patients. Electroencephalography (EEG) provides a promising approach for predicting the risk of POD. This study aims to elucidate the correlation between intraoperative EEG spectrum and the incidence of POD in elderly patients undergoing orthopedic surgery.

The Effect of Early Enteral Nutrition under the ERAS Model on Gastrointestinal and Immune Function Recovery in Patients Undergoing Gastric Tumor Surgery.

Aim: Patients with gastric malignant tumors usually undergo surgical treatment when indicated. Surgical intervention causes significant trauma and can lead to considerable stress responses in patients. These patients experience increased malnutrition along with reduced immune function, which ultimately leads to the occurrence of postoperative complications.

Involvement of the parabrachial nucleus in emergence from general anesthesia.

The parabrachial nucleus (PBN), located in the dorsolateral pons, is involved in many important biological functions, such as sensory signaling, feeding, defensive behaviors, fear, anxiety, and sleep-wake cycles. General anesthesia shares the classical feature of reversible loss of consciousness with natural sleep, and accumulating evidence has indicated that general anesthesia and sleep-wake behaviors share some common underlying neural mechanism. In recent years, emerging studies have investigated the involvement of PBN in emergence from general anesthesia, but divergence exists in terms of different types of general anesthetics or different durations of treatment with the same group of general anesthetics.

Transcutaneous Electrical Nerve Stimulation for Prevention and Treatment of Post-Herpetic Neuralgia: A Narrative Review.

The present investigation evaluated transcutaneous electrical nerve stimulation (TENS) for the non-pharmacological treatment of post-herpetic neuralgia (PHN). PHN is the most common complication of the Herpes Zoster virus, affecting one in every five patients with shingles, and presents as intense neuropathic pain that can persist for 90 days or longer after the initial onset of symptoms. Current pharmacological treatment options are mainly limited to symptom management, including oral medications such as tricyclic antidepressants and gabapentinoid preparations, as well as topical options such as lidocaine or capsaicin.

Emergency Debulking of Recurrent Respiratory Papillomatosis: An Anesthesia Challenge.

Recurrent respiratory papillomatosis (RRP) is a rare condition involving the recurrent growth of benign papillomas in the respiratory tract caused exclusively by human papillomavirus (HPV). We present the case of a five-year-old child who arrived at the emergency department with severe respiratory distress, hoarseness, and biphasic stridor. The patient required urgent transfer to the operating room for the emergency debridement of papillomas.

The nociceptive withdrawal reflex during spinal analgesia in pigs undergoing veno-arterial extracorporeal membrane oxygenation: a prospective observational study.

Introduction: Use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is still in the focus of research, in which pigs are commonly involved. During VA-ECMO, cardiovascular parameters are artificially manipulated and therefore not reliable indicators of nociception. Nociceptive withdrawal reflex (NWR) thresholds can be a suitable alternative in such a context.

Optimizing Cervical Epidural Steroid Injections: A Case Report.

Cervical radiculopathy is characterized by pain, numbness, and weakness in the upper limbs. This is typically caused by nerve root compression. While conservative treatments like physical therapy and oral analgesics are often used, they may not be effective in more severe cases.