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J Neurosurg Pediatr 2021 Apr 16:1-11. Epub 2021 Apr 16.

1Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London.

Objective: Deep brain stimulation (DBS) is an established treatment for pediatric dystonia. The accuracy of electrode implantation is multifactorial and remains a challenge in this age group, mainly due to smaller anatomical targets in very young patients compared to adults, and also due to anatomical abnormalities frequently associated with some etiologies of dystonia. Data on the accuracy of robot-assisted DBS surgery in children are limited. Read More

ACS Chem Neurosci 2021 Apr 16. Epub 2021 Apr 16.

Institute of Biochemistry and Molecular Biology, School of Life Sciences, Lanzhou University, 222 Tianshui South Road, Lanzhou, Gansu 730000, China.

MOTS-c is a 16-amino acid mitochondrial derivative peptide reported to be involved in regulating insulin and metabolic homeostasis via the AMP activated protein kinase (AMPK). AMPK agonist AICAR has been reported to improve cognition. Previous reports also pointed out that MOTS-c may be effective as a therapeutic option toward the prevention of the aging processes. Read More

Infect Dis Ther 2021 Apr 16. Epub 2021 Apr 16.

Department of Anesthesia, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.

Introduction: Catheter management strategies for suspected catheter-related bloodstream infection (CRBSI) remain a major challenge in intensive care units (ICUs). The objective of this study was to determine the incidence, risk factors, and mortality attributable to CRBSIs in those patients.

Methods: A population-based surveillance on suspected CRBSI was conducted from 2009 to 2018 in a tertiary care hospital in China. Read More

Anaesthesia 2021 Apr 16. Epub 2021 Apr 16.

NHS Blood and Transplant and Consultant, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Between 2013 and 2019, there was an increase in the consent rate for organ donation in the UK from 61% to 67%, but this remains lower than many European countries. Data on all family approaches (16,896) for donation in UK intensive care units or emergency departments between April 2014 and March 2019 were extracted from the referral records and the national potential donor audit held by NHS Blood and Transplant. Complete data were available for 15,465 approaches. Read More

Oxid Med Cell Longev 2021 30;2021:6655122. Epub 2021 Mar 30.

Department of Biological Sciences Division-Cardiology, University of Chicago, USA.

Background: The blood-brain barrier (BBB) regulates the exchange of molecules between the brain and peripheral blood and is composed primarily of microvascular endothelial cells (BMVECs), which form the lining of cerebral blood vessels and are linked via tight junctions (TJs). The BBB is regulated by components of the extracellular matrix (ECM), and matrix metalloproteinase 3 (MMP3) remodels the ECM's basal lamina, which forms part of the BBB. Oxidative stress is implicated in activation of MMPs and impaired BBB. Read More

Thorax 2021 Apr 15. Epub 2021 Apr 15.

Department of Anaesthesia, Critical Care & Pain Medicine and Usher Institute, The University of Edinburgh, Edinburgh, UK.

Purpose: To determine the effect of depth of sedation on intensive care mortality, duration of mechanical ventilation, and other clinically important outcomes.

Methods: We searched MEDLINE, Embase, Cochrane Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO from 2000 to 2020. Randomised controlled trials (RCTs) and cohort studies that examined the effect of sedation depth were included. Read More

J Cardiothorac Vasc Anesth 2021 Mar 10. Epub 2021 Mar 10.

Department of Anesthesia, Austin Hospital, Heidelberg, Victoria, Australia.

Objectives: Quantification of the tricuspid annulus (TA) is an important factor in determining the requirement for tricuspid annuloplasty in cardiac surgery. Three-dimensional echocardiography (3DE) has shown that the TA is biplanar with an antero-posterior longaxis and septo-lateral shortaxis, and that the commonly used 2D TEE (two-dimensional transesophageal echocardiography) four-chamber view (4ChV) underestimates the true TA longaxis. The authors hypothesized that the use of multiple 2D TEE TA views could attain greater TA long-axis measurements and smaller TA short-axis measurements than the 4ChV, and that the 4ChV has a significant but inconsistent bias relative to the maximal TA diameter measured by these views. Read More

Anesth Analg 2021 May;132(5):1296-1305

Division of Pulmonary, Critical Care and Sleep Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.

There is common ground between the specialties of anesthesiology and sleep medicine. Traditional sleep medicine curriculum for anesthesiology trainees has revolved around the discussion of obstructive sleep apnea (OSA) and its perioperative management. However, it is time to include a broader scope of sleep medicine-related topics that overlap these specialties into the core anesthesia residency curriculum. Read More

Urol Int 2021 Apr 15:1-8. Epub 2021 Apr 15.

Department of Urology, Second Hospital of Hebei Medical University, Shijiazhuang, China.

Introduction: The purpose of this article is to evaluate the efficacy and safety of prestenting (PS) versus non-PS (NPS) of flexible ureteroscopy (fURS) to treat large upper urinary stones.

Methods: We conducted a systematic literature research of PubMed, Ovid, Scopus (up to August 2019), and citation lists to identify eligible studies. All studies comparing PS versus NPS of fURS were included. Read More

Sleep 2021 Apr 15. Epub 2021 Apr 15.

Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, MA, USA.

Study Objectives: Sleep spindles are defined based on expert observations of waveform features in the electroencephalogram traces. This is a potentially limiting characterization, as transient oscillatory bursts like spindles are easily obscured in the time-domain by higher amplitude activity at other frequencies or by noise. It is therefore highly plausible that many relevant events are missed by current approaches based on traditionally-defined spindles. Read More

Anesth Analg 2021 Apr 15. Epub 2021 Apr 15.

From the Global Medical Affairs, AbbVie Inc, North Chicago, Illinois.

With an estimated worldwide volume of 266 million surgeries in 2015, the call for general inhalation anesthesia is considerable. However, widely used volatile anesthetics such as N2O and the highly fluorinated gases sevoflurane, desflurane, and isoflurane are greenhouse gases, ozone-depleting agents, or both. Because these agents undergo minimal metabolism in the body during clinical use and are primarily (≥95%) eliminated unchanged via exhalation, waste anesthetic gases (WAGs) in operating rooms and postanesthesia care units can pose a challenge for overall elimination and occupational exposure. Read More

Anesth Analg 2021 Apr 15. Epub 2021 Apr 15.

From the Department of Anesthesiology and Perioperative Medicine.

Background: Propofol administration in patients with Brugada syndrome (BrS) is still a matter of debate. Despite lacking evidence for its feared arrhythmogenicity, up to date, expert cardiologists recommend avoiding propofol. The main aim of this study is to assess the occurrence of malignant arrhythmias or defibrillations in patients with BrS, during and 30 days after propofol administration. Read More

J Am Vet Med Assoc 2021 May;258(9):1007-1010

Case Description: A 12-year-old Friesian stallion was examined because of a 1-year history of preputial injury and urination through a urethrocutaneous fistula located at the midbody of the ventral aspect of the penis.

Clinical Findings: Physical examination revealed an opening with a clearly apparent mucocutaneous junction 12 cm from the distal opening of the urethra on the ventral left side of the penis. Endoscopic examination of the distal portion of the urethra confirmed a blind pouch with no communication with the fistula or proximal portion of the urethra. Read More

Pediatr Surg Int 2021 Apr 15. Epub 2021 Apr 15.

Department of Pediatric Surgery, Medical Faculty of Dicle University, Diyarbakir, AZ, 21000, Turkey.

Background: The aim of this study was to present our experience in the use of crystallized phenol (CP) to treat pediatric patients with 'simple' and complex' Pilonidal sinus disease (PSD).

Materials And Methods: Patients who underwent CP treatment in between January 2015 and January 2020 were evaluated retrospectively, using prospectively collected data. The patients were divided into simple and complicated groups. Read More

Ann Surg 2021 Apr 7. Epub 2021 Apr 7.

Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China Department of Anesthesia, the First Affiliated Hospital of Guangzhou Medical University.

Objective: We aim to report a novel surgical technique that robotic-assisted thoracoscopic surgery combined with non-intubated spontaneous ventilation to perform tracheal/airway surgery.

Summary Background Data: Our team has demonstrated video-assisted transthoracic surgery (VATS) can be used for thoracic tracheal diseases with satisfactory outcomes. Our team has also demonstrated that tracheal/ airway resection and reconstruction under spontaneous ventilation can improve the anastomosis and operating time. Read More

J Endovasc Ther 2021 Apr 15:15266028211007466. Epub 2021 Apr 15.

Vascular Unit, 1st University Surgical Department, Aristotle University, General Hospital Papageorgiou, Thessaloniki, Greece.

Objective: The aim of this study was to provide early-term evaluation, safety, and efficacy of the novel CGuard (Inspire MD, Tel Aviv, Israel) micromesh self-expanding stent with embolic protection system (EPS) during carotid artery stenting (CAS) procedure.

Materials And Methods: All patients who underwent CAS with CGuard carotid stent system from January 2018 to September 2020 in a tertiary center were prospectively evaluated. Primary endpoints included technical success and perioperative neurological events (0-48 hours). Read More

Neurol Sci 2021 Apr 14. Epub 2021 Apr 14.

Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, People's Republic of China.

Objective: The efficacy and safety of deep brain stimulation (DBS) under general anesthesia for the treatment of dystonia have not yet been confirmed with high level of evidence. This meta-analysis with pooled individual patient data aims to assess the clinical outcomes and identify the potential prognostic factors of dystonia patients who underwent general anesthesia DBS.

Methods: We searched PubMed, Web of Science, and Embase for articles describing patients with dystonia who underwent asleep DBS and had individual Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) scores. Read More

Orthop J Sports Med 2021 Mar 29;9(3):2325967121994203. Epub 2021 Mar 29.

Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Background: Many factors can affect clinical outcomes and complications after a complex multiligament knee injury (MLKI). Certain aspects of the treatment algorithm for MLKI, such as the timing of surgery, remain controversial.

Purpose: To determine the risk factors for common complications after MLKI reconstruction. Read More

Front Vet Sci 2021 29;8:655345. Epub 2021 Mar 29.

Department of Forestry and Wildlife Management, Inland Norway University of Applied Sciences, Koppang, Norway.

Three medetomidine-based drug protocols were compared by evaluating time courses, reliability and physiological effects in wild boars. A total of 21 cage-trapped wild boars () were immobilized using one of the following drug combinations; MTZ: medetomidine (0.2 mg/kg) + tiletamine-zolazepam (2. Read More

Plast Reconstr Surg Glob Open 2021 Apr 8;9(4):e3513. Epub 2021 Apr 8.

Division of Plastic and Reconstructive Surgery, Université de Montréal, Montréal, Québec, Canada.

Background: Carpal tunnel syndrome and trigger finger are two of the most common conditions treated by the hand surgeon. During these procedures, a tourniquet is often used to minimize bleeding and improve visualization of the operative field. However, it may be associated with pain and discomfort. Read More

Front Neurol 2021 29;12:640841. Epub 2021 Mar 29.

Department of Neurology, Zhejiang Provincial People's Hospital, Hangzhou, China.

Optimal periprocedural management of blood pressure during mechanical thrombectomy (MT) remains controversial. This study aimed to investigate the relationship between the duration of blood pressure drops during general anesthesia and the outcomes in large vessel occlusion (LVO) patients treated with MT. We retrospectively reviewed our prospectively collected data for LVO patients treated with MT between January 2018 and July 2020. Read More

Front Hum Neurosci 2020 23;14:568051. Epub 2021 Mar 23.

University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation (tVNS) across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation(VNS) and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between studies, replication of studies, as well as enhancing study participant safety. Read More

Drug Des Devel Ther 2021 7;15:1485-1493. Epub 2021 Apr 7.

Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, People's Republic of China.

Purpose: To evaluate the effectiveness and safety of lidocaine on postoperative quality of recovery and lung protection of patients undergoing thoracoscopic radical resection of lung cancer.

Patients And Methods: Seventy ASA II-III patients undergoing thoracoscopic radical resection of lung cancer were randomly assigned into either the lidocaine group (Group L) or control group (Group C). Patients in Group L received lidocaine with a 1. Read More

Sci Rep 2021 Apr 14;11(1):8161. Epub 2021 Apr 14.

Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.

The conciliation between career and family is a relevant issue for working women, in particular during the first years of motherhood. Data about the state of the cardiac autonomic regulation in working women with preschoolers are lacking. Aim of this study was to compare the cardiac autonomic profile of female healthcare professionals with and without preschoolers via the analysis of the variability of the time distance between two consecutive R-wave peaks (RR) from standard 24-h Holter electrocardiogram (ECG). Read More

Microbiome 2021 04 14;9(1):91. Epub 2021 Apr 14.

Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

Background: Coronavirus disease 2019 (COVID-19) caused by the enveloped RNA virus SARS-CoV-2 primarily affects the respiratory and gastrointestinal tracts. SARS-CoV-2 was isolated from fecal samples, and active viral replication was reported in human intestinal cells. The human gut also harbors an enormous amount of resident viruses (collectively known as the virome) that play a role in regulating host immunity and disease pathophysiology. Read More

Int J Hyperthermia 2021 ;38(1):604-610

School of Medicine, Nankai University, Tianjin, China.

Purpose: To evaluate the efficacy and safety of radiofrequency ablation for low-risk papillary thyroid microcarcinoma (PTMC) in patients aged 55 years or older.

Methods: This retrospective study included 95 patients aged 55 years or older who underwent radiofrequency ablation (RFA) for PTMCs between June 2014 and January 2019. Incidence and duration of postoperative complications were recorded and evaluated. Read More

Fetal Diagn Ther 2021 Apr 14:1-8. Epub 2021 Apr 14.

Department of Anesthesiology, Perioperative and Pain Medicine,Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.

Background: The fetoscopic approach to the prenatal closure of a neural tube defect (NTD) may offer similar advantages to the newborn compared to prenatal open closure of a NTD, with a reduction in maternal risks. Enhanced recovery after surgery (ERAS) protocols have been applied to different surgical procedures with documented advantages. We modified the perioperative care of patients undergoing in utero repair of myelomeningocele with the goal of enhancing the recovery. Read More

Eur J Gastroenterol Hepatol 2021 Apr 9. Epub 2021 Apr 9.

Department of Anaesthesiology, Southwest Hospital, Army Medical University, Chongqing Department of Anesthesia, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China LBCMCP, Centre de Biologie Intégrative (CBI), Université de Toulouse, CNRS, UPS, Toulouse, France Department of Anaesthesiology, Renji Hospital affiliated to Shanghai Jiao Tong University, Shanghai Department of Anaesthesiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.

Background: This study attempted to investigate the impact of hepatopulmonary syndrome (HPS) on postoperative outcomes in hepatitis B virus-induced hepatocellular carcinoma (HBV-HCC) patients.

Methods: HBV-HCC patients undergoing primary curative hepatectomy for HCC in our hospital were diagnosed with HPS by contrast-enhanced echocardiography (CEE) and arterial blood gas analysis. Patients were divided into HPS, intrapulmonary vascular dilation (IPVD) (patients with positive CEE results and normal oxygenation) and control (patients with negative CEE results) groups. Read More

Curr Opin Crit Care 2021 Apr 14. Epub 2021 Apr 14.

Interdepartmental Division of Critical Care Medicine, University of Toronto Toronto Western Hospital, University Health Network Krembil Research Institute, Toronto Western Hospital Department of Critical Care Medicine, Sunnybrook Health Sciences Centre Department of Critical Care, St. Michael's Hospital Toronto, University of Toronto Department of Anesthesia, Keenan Research Centre for Biomedical Science, St. Michael's Hospital Toronto, University of Toronto, Toronto, Ontario, Canada.

Purpose Of Review: Over 40% of patients with severe traumatic brain injury (TBI) show clinically significant neurological worsening within the acute admission period. This review addresses the importance of identifying the crashing TBI patient, the difficulties appreciating clinical neurological deterioration in the comatose patient and how neuromonitoring may provide continuous real-time ancillary information to detect physiologic worsening.

Recent Findings: The latest editions of the Brain Trauma Foundation's Guidelines omitted management algorithms for adult patients with severe TBI. Read More

J Bone Joint Surg Am 2021 Apr;103(8):660-667

Department of Orthopaedic Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, Missouri.

Background: Knee arthroscopy may be performed prior to total knee arthroplasty (TKA) in patients with symptomatic degenerative knee changes that do not yet warrant TKA. The purpose of this study was to determine whether the time interval between knee arthroscopy and subsequent primary TKA is associated with increased rates of revision and certain complications following TKA.

Methods: Data from 2006 to 2017 were collected from a national insurance database. Read More