British journal of anaesthesia
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Multicenter Study Observational Study
Preoperative anaemia and outcome after elective cardiac surgery: a Dutch national registry analysis.
Previous studies have shown that preoperative anaemia in patients undergoing cardiac surgery is associated with adverse outcomes. However, most of these studies were retrospective, had a relatively small sample size, and were from a single centre. The aim of this study was to analyse the relationship between the severity of preoperative anaemia and short- and long-term mortality and morbidity in a large multicentre national cohort of patients undergoing cardiac surgery. ⋯ Preoperative anaemia was associated with mortality and morbidity after cardiac surgery. The risk of adverse outcomes increased with anaemia severity. Preoperative anaemia is a potential target for treatment to improve postoperative outcomes.
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Editorial
Mandatory vaccination of National Health Service staff against COVID-19: more harm than good?
Despite the clear benefits of vaccination against COVID-19, there was significant unease relating to the government policy of mandatory vaccination of health and care staff in England and the potential inequities this may lead to. Healthcare staff, and in particular doctors, speaking out on this issue may have inadvertently provided a narrative, which undermined the objective of achieving widespread vaccination of populations against this serious disease. The recent reversal of this policy may not mark the end of this debate amongst health and social care staff.
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Postoperative pain is a common clinical problem that, in preclinical studies, has almost exclusively been studied in males. Altered C-fibre activity-dependent slowing (ADS) is a potential underlying mechanism, given it is altered after tissue inflammation and nerve injury, but this has not been explored post-incision. We therefore investigated the effect of hind-paw incision on C-fibre ADS in both sexes and the involvement of voltage-gated sodium channels (NaV) as they contribute to ADS. We also assessed mechanical and thermal sensitivity post-incision in both sexes. ⋯ Hind-paw incision induces sex-dependent changes in C-fibre activity-dependent slowing, which likely contribute to the observed sex difference in peak thermal hypersensitivity. This may reflect sex- and incision-induced differences in functional expression of NaV channels that differs by C-fibre subtype.