Articles: cations.
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Minerva anestesiologica · Apr 2023
Electroencephalographic Density Spectral Array monitoring in pediatric anesthesia: clinical background and practical applications.
Depth of hypnosis monitoring using numerical index based processed electroencephalography is part of the standard anesthesia equipment in many operating rooms. Unfortunately, this method has its limitations, especially in pediatric patients. ⋯ Electroencephalographic density spectral array (DSA) monitoring is a real-time technique that can be used in all age groups and with all common anesthetics. We present a practice-oriented introduction to the principle of DSA monitoring in pediatric anesthesia for pediatric anesthesiologists and two algorithms for using this technology in children under sevoflurane and propofol anesthesia.
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Hypertension (HTN) is a common endpoint for numerous cardiovascular diseases, the prevalence of which has been quickly increasing due to a wide range of reasons. Previous research has found that following stress, ELISA and 16S rDNA sequencing indicated substantial changes in plasma cytokines or hormones, as well as alterations in gut microbiota in juvenile hypertensive rats. However, it remains still unclear how such interaction modifications affect microbial populations and organismal function. ⋯ Significant improvements in bacteria linked with short-chain fatty acid synthesis, such as Prevotella and Ruminococcus, were discovered by metagenomic analysis. Adult hypertensive rats are more susceptible to gut microbiota disruption and fibrosis as a result of mild restraint stress. This might contribute to some innovative ideas for HTN both treatment and prevention.
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Functional magnetic resonance imaging has been used to investigate nociceptive processes in patients with chronic pain. However, the results may be confounded with changes in neurovascular coupling induced by chronic pain. The objective of this study was to examine spinal neurovascular coupling in a rat model of chronic back pain induced by muscle inflammation. ⋯ Nevertheless, neurovascular coupling was comparable between groups on days 14 and 28, whether neurovascular coupling was calculated with the amplitude or the area under the curve of SCBF responses (all P > 0.2). These results indicate that spinal hemodynamic changes reflect neuronal activity in this animal model, although the time course of SCBF responses is affected by chronic inflammatory back pain. This warrants a careful use of spinal functional magnetic resonance imaging in animal models and patients with chronic back pain.
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This study aims to investigate at-risk scores of semiannual Accreditation Council for Graduate Medical Education (ACGME) Milestone ratings for vascular surgical trainees' final achievement of competency targets. ⋯ The ACGME Milestones provide early diagnostic and predictive information for vascular surgery trainees' achievement of competence at completion of training.
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Anesthesia and analgesia · Apr 2023
Pro-Con Debate: Videolaryngoscopy Should Be Standard of Care for Tracheal Intubation.
In this Pro-Con commentary article, we discuss whether videolaryngoscopy (VL) should be the standard of care for tracheal intubation. Dr Aziz makes the case that VL should be the standard of care, while Dr Berkow follows with a challenge of that assertion. In this debate, we explore not only the various benefits of VL, but also its limitations. ⋯ While cost is a barrier to broad implementation of VL, those costs are normalizing. However, it may still be challenging for institutions to secure purchase of VL for every intubating location, as well as back-up airway devices. As airway management care increasingly transitions from DL to VL, providers should be aware of the benefits and risks to this practice change.