A study of the relationship between Bispectral index and age-adjusted minimum alveolar concentration during the maintenance phase of general anesthesia in elective surgery.

Background And Aims: Bispectral index (BIS) and minimum alveolar concentration (MAC) are commonly used to monitor the depth of anesthesia. The objective was to study the correlation between BIS and age-adjusted minimum alveolar concentration (aaMAC) during the maintenance phase of anesthesia. The influence of variables affecting BIS and or aaMAC was studied to determine an equation between BIS and aaMAC.

A new device, LMA Gastro™, on the horizon for endoscopy procedures: A narrative review.

Interventional endoscopy procedures are challenging for anaesthesiologists due to the various patient, procedural, logistic, and position-related issues. Complex endoscopic procedures like biliary interventions and endoscopic myotomy necessitate longer procedural duration. The mode of anaesthesia is usually deep sedation without any definitive airway device and is frequently associated with hypoxemia events which can be catastrophic.

Efficacy and safety of sublingual buprenorphine in managing acute postoperative pain - A systematic review.

Sublingual (SL) buprenorphine has been used as a modality of managing acute postoperative pain in many studies. This systematic review aimed to investigate the safety and efficacy of SL buprenorphine as an analgesic for various surgeries. After registering the protocol with PROSPERO, we searched PubMed, Cochrane Library, and Ovid databases with relevant keywords.

Reprogramming of fibroblasts into cancer-associated fibroblasts via IGF2-mediated autophagy promotes metastasis of lung cancer cells.

Cancer-associated fibroblasts (CAFs) are major component of stromal cells. Growing evidence suggests that CAFs promote tumor growth and metastasis; however, the reprogramming of normal fibroblasts (NFs) into CAFs by tumor cells still remains largely unknown. In this study, we found that non-small cell lung cancer (NSCLC) cells activated NFs into CAFs via autophagy induction.

Eosinophil count and clinical outcome in patients with acute exacerbation of Chronic obstructive pulmonary disease.

Introduction: We examined the association of blood eosinophil counts at the time of AECOPD hospitalization with the risk of ICU admission as well as the hospital lengths of stay and mortality.

Methods: In the current retrospective study, the association between blood eosinophil counts in COPD patients at the time of AECOPD hospitalization and the risk of subsequent ICU admission as well as mortality was assessed. The chi-squared test and t-test were used to compare categorical and continuous variables.

Intraosseous basivertebral nerve ablation: A 5-year pooled analysis from three prospective clinical trials.

Background: Vertebrogenic pain is a documented source of anterior column chronic low back pain (CLBP) that stems from damaged vertebral endplates. Nociceptive signals are transmitted by the basivertebral nerve (BVN) and endplate damage is observed as Type 1 or Type 2 Modic changes (MC) on magnetic resonance imaging (MRI). The clinical impact and safety of intraosseous radiofrequency ablation of the BVN (BVNA) for the treatment of vertebrogenic pain has been demonstrated in three prospective clinical trials (two randomized and one single-arm study).

Long-term Complications From Peripheral Nerve Blocks After Pediatric Orthopaedic Lower Extremity Procedures: A Systematic Review.

Background: Peripheral nerve blocks (PNBs) are frequently utilized as a regional anesthetic in pediatric orthopaedic surgery for postoperative pain control and reduced time to discharge; however, short- and long-term complications after these procedures are variably reported.

Purpose: To identify the frequency of long-term complications in pediatric patients who received regional anesthesia for a lower extremity orthopaedic procedure.

Study Design: Systematic review; Level of evidence, 4.

Chemical, biological and nerve gas attacks: need for education among healthcare personnel and medical students; a Swedish regional cross-sectional web-survey.

Background: Chemical, biological and nerve gas events have a significant impact on public health, necessitating proper education and training. This study investigated the educational needs as perceived by two groups, frontline healthcare workers and medical students, in relation to chemical, biological, and nerve gas events.

Methods: Three distinct web-based cross-sectional surveys were conducted, one each for chemical, biological, and nerve gas events, with each survey following the same structural format including sections on (a) theoretical knowledge assessment, using multiple-choice questions regarding identification, protection, and treatment, (b) perception of threat, using questions based on a 5-point Likert scale to gauge views on threat/preparedness and (c) perception of existing competency, with questions regarding prior education and the need for additional education and training.

CK2-dependent SK channel dysfunction as contributor to neuronal hyperexcitability in Alzheimer's disease.

Neuronal hyperexcitability in the cortex and hippocampus represents an early event in Alzheimer's disease (AD). In a recent study, Blankenship and colleagues reported that in a mouse of AD, ventral tegmental area (VTA) dopamine neurons are also hyperexcitable, and this hyperexcitability is due to casein kinase 2 (CK2)-dependent SK channel dysfunction, adding new insights into the underlying mechanisms of aberrant neuronal properties in AD.

Successful Antibiotic Treatment of Phlegmonous Gastritis Following Allogeneic Hematopoietic Stem Cell Transplantation.

Phlegmonous gastritis (PG) is a rare, life-threatening bacterial infection characterized by thickening of the gastric wall. We report a case of PG in a 17-year-old male following allogeneic hematopoietic stem cell transplantation for severe aplastic anemia. Seven months after transplantation, the patient presented with severe abdominal pain, fever, and significant gastric wall thickening on CT.

Hierarchy in surgeon-anaesthetist relationships.

Operating theatres are steeply hierarchical, and yet the hierarchy between surgeons and anaesthetists is unclear, even blurry. Both the steep hierarchy and the blurriness at the top can present a risk to patient safety through inhibiting speaking up with concerns and negotiating safe patient care. A recent study in the British Journal of Anaesthesia explores hierarchy in the surgeon-anaesthesia dyad in China, in particular, the effect of increased seniority gap between surgeons and anaesthetists on anaesthesia-related adverse outcomes.

Prioritising mental health in the perioperative period: understanding postoperative patterns in anxiety and depression through ecological momentary assessment.

A recent study in the British Journal of Anaesthesia examining trajectories of anxiety and depressive symptoms after diverse surgical procedures sheds light on an often overlooked, yet important, factor in postoperative recovery-mental health. The authors applied ecological momentary assessment to collect high-resolution data to identify and characterise a subgroup of vulnerable patients who experience worsening of psychological symptoms after surgery. The study prompts not only consideration of psychological factors, but also how best to leverage ecological momentary assessment to understand the perioperative experience.

The fine line between relief and risk: new insights into postoperative delirium.

There is a complex association between postoperative pain and postoperative delirium, which highlights the need for a more balanced approach to pain management that considers various risk factors. We emphasise the importance of comprehensive documentation and standardised monitoring to improve detection and management of postoperative delirium, ultimately enhancing patient outcomes. We advocate for a precision anaesthesia approach, which tailors care to individual patient profiles, as a potential solution to address these challenges.

Serinc2 antagonizes pressure overload-induced cardiac hypertrophy via regulating the amino acid/mTORC1 signaling pathway.

Background: Cardiac hypertrophy is characterized by the upregulation of fetal genes, increased protein synthesis, and enlargement of cardiac myocytes. The mechanistic target of rapamycin complex 1 (mTORC1), which responds to fluctuations in cellular nutrient and energy levels, plays a pivotal role in regulating protein synthesis and cellular growth. While attempts to inhibit mTORC1 activity, such as through the application of rapamycin and its analogs, have demonstrated limited efficacy, further investigation is warranted.

BLOOD PROTEOMICS AND MULTIMODAL RISK PROFILING of human volunteers after incision injury: a translational study for advancing Personalized Pain Management After Surgery.

A significant number of patients develop chronic pain after surgery, but prediction of those who are at risk is currently not possible. Thus, prognostic prediction models that include bio-psycho, social and physiological factors in line with the complex nature of chronic pain would be urgently required. Here, we performed a translational study in male volunteers before an experimental incision injury.

Identification of Cannabis Product Characteristics and Pricing on Dark Web Markets.

Growing cannabis use has made it the most widely cultivated and trafficked illicit drug globally according to the World Health Organization, with 147 million people consuming cannabis-derived products (CDPs) in various product forms and constituency. Despite restrictions in certain countries, unregulated access can still be found on the dark web which specializes in trafficking of illicit goods. The objective was to systematically collect data from multiple marketplaces to identify types of cannabis products offered for sale.

Surgical frequency analysis of patients clustered according to postoperative pain trajectory: a retrospective study.

Oropharyngeal and orthognathic surgeries cause more postoperative pain than simple dental procedures. The lack of detailed pain pattern analysis after dental surgeries makes pain management challenging. We assessed postoperative pain patterns in patients undergoing various dental surgeries, categorized based on changing pain levels, and identified the most frequent surgical procedures within each pain pattern cluster.

Videolaryngoscopy is associated with a lower rate of double-lumen endotracheal tube malposition in thoracic surgery procedures, retrospective single-center study.

Abstarct: BACKGROUND: The optimal positioned double-lumen endotracheal tubes (DLT) is crucial in thoracic surgery requiring lung isolation. This study aims to compare the accuracy and complication rates of DLT placement using videolaryngoscopy (VL) versus conventional direct laryngoscopy (DL).

Methods: This retrospective single-center study included 89 patients who underwent thoracic surgery with DLT placement between July 2023 and May 2024.

Heparin rebound in patients undergoing off-pump coronary artery bypass grafting surgery: a single-center retrospective study.

Background: Heparin, an anticoagulant used in cardiac surgery, can result in heparin rebound (HR), where it returns postoperatively despite being neutralized with protamine. This study was designed to investigate the prevalence of HR in patients undergoing off-pump coronary artery bypass grafting (OPCAB) and evaluate the impact of HR on their short-term outcomes.

Methods: HR was defined by a 10% increase in activated coagulation time (ACT) following two hours of heparin neutralization with protamine, bleeding over 200 mL/h, and abnormal laboratory coagulation examination results.