Postgraduate medical journal
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To determine the conditions that prevented transplant in patients referred to our center due to end-stage lung disease. ⋯ Impaired performance status was the most common cause of lung transplant exclusion. Weight and smoking were preventable causes of exclusion. Implementing pulmonary rehabilitation in very few patients was the most important handicap. It is believed that providing optimal treatment with a multidisciplinary approach and timely referral to transplant centers will significantly reduce the reasons for exclusion. Key message What is already known on this topic? Referring lung transplant candidates to clinics at the earliest stage is essential for assessing their condition and exploring treatment options. What this study adds? Factors like smoking, obesity, and muscle loss can hinder the transplantation process; thus, timely interventions are crucial. The primary reason for excluding candidates from lung transplantation is the decline in performance status. How this study might affect research, practice or policy? Programs focused on smoking cessation, weight management, and muscle strengthening can play a vital role in enhancing patients' health before transplantation. It is imperative to expand and enhance the accessibility of pulmonary rehabilitation programs.
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This study was aimed to identify serum proteins linked with gastrointestinal diseases by proteome-wide Mendelian randomization analysis. ⋯ The proteome-wide Mendelian randomization investigation identified several circulating proteins associated with the risk of UC, CD, diverticular disease and cholelithiasis, which reinforced the understanding of molecular pathogenesis and design of therapeutic targets.
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Epilepsy, a chronic neurological condition marked by recurrent, unprovoked seizures, involves complex pathophysiological mechanisms. Recent advancements have expanded our understanding from traditional neuronal dysfunction to include neuroimmune interactions and the influence of the brain-gut-bio-axis. ⋯ The review integrates findings from recent studies, emphasizing the critical role of the S100b signalling pathway and the gut-brain axis in epilepsy pathology. The interplay between neuroimmune mechanisms and gut microbiota offers novel insights and potential therapeutic targets, underlining the need for further research to exploit these connections for clinical benefit.
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Trauma remains a leading cause of death, both for individuals under 40 in North America, and globally, where it contributes to ~10% of deaths annually. Thoughtful, timely, balanced resuscitation, especially in the peri-operative period for unstable injured surgical patients, is vital for optimizing outcomes. The advanced trauma life support protocol plays a pivotal role in early evaluation and management, emphasizing hemorrhage control and resuscitation strategies. ⋯ This review serves as an educational resource for surgical trainees, equipping them with a robust understanding of evidence-based trauma resuscitation. By integrating historical context, modern practices, and emerging technologies, the review aims to enhance both the theoretical knowledge and practical skills necessary for managing unstable trauma patients. Emphasis is placed on interdisciplinary teamwork, continuous education, and personalized resuscitation strategies to improve clinical outcomes.
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This study aims to provide a comprehensive overview of the antidepressant and antisuicidal efficacy of ketamine in patients with unipolar depression, with a focus on the clinical evidence and safety profile. ⋯ The findings of this study are in line with those from previous research that demonstrated the rapid and robust antidepressant effects of ketamine, even in individuals with severe, treatment-resistant depression. Moreover, the observed reduction in suicidal ideation is particularly noteworthy, given the critical need for interventions that can provide rapid relief in acute suicidal crises. Key message What is already known on this topic - Ketamine is known for its rapid antidepressant and antisuicidal effects in treatment-resistant major depressive disorder, demonstrating significant symptom relief within hours of administration. What this study adds - This study provides additional evidence supporting ketamine's rapid efficacy in reducing depressive symptoms and suicidal ideation, highlighting statistically significant improvements observed at 4 and 24 hours post-treatment. How this study might affect research, practice, or policy - The findings may encourage broader clinical adoption of ketamine for acute depressive episodes and suicidality, emphasizing the need for controlled medical settings to manage potential side effects, and could influence future research on optimizing dosing protocols and long-term safety.