Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2019
Contemporary Academic Contributions From Anesthesiologists in Adult Critical Care Medicine.
Anesthesiology has a long relationship with critical care medicine (CCM). However, US anesthesiologists are less likely to practice CCM than non-US anesthesiologists. To date, no studies have compared academic contributions in CCM between US anesthesiologists and non-US anesthesiologists. The objective of our study was to use recent trends in critical care publications as a surrogate for academic contribution among US and non-US anesthesiologists. ⋯ When compared to non-US anesthesiologists, US anesthesiologists had more CCM publications in anesthesiology journals and fewer publications in multidisciplinary CCM journals. The number of anesthesiology CCM publications decreased for both US and non-US anesthesiologists throughout the study period.
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Anesthesia and analgesia · Aug 2019
Propofol Regulates Neural Stem Cell Proliferation and Differentiation via Calmodulin-Dependent Protein Kinase II/AMPK/ATF5 Signaling Axis.
Propofol can cause degeneration of developing brain cells and subsequent long-term learning or memory impairment. However, at the early stage of embryonic development, the molecular mechanism of propofol-induced inhibition in neural stem cells (NSCs) neurogenesis is still unclear. The aim of this study was to determine the role of propofol in NSCs neurogenesis and, more importantly, to explore the underlying mechanism. ⋯ The results from study demonstrated that propofol inhibits the proliferation, differentiation, and migration of NSCs, and these effects are partially mediated by CaMkII/pS485/AMPK/ATF5 signaling pathway.
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Anesthesia and analgesia · Aug 2019
Comparative StudyRetrospective Comparison of 2 Management Strategies for Perioperative Malaria Episodes in Pediatric Patients in a Limited-Resource Setting.
Malaria is a common problem throughout the world, particularly in sub-Saharan Africa, where 90% of all deaths in the world from malaria occur. While many studies on malaria are available in the medical literature, few publications have addressed the problems of managing malaria during surgery and anesthesia. At a newly opened hospital in Niger, we initiated further studies to evaluate our process of managing malaria when we had a number of problems in our first group of pediatric patients having elective cleft lip and palate repairs. Many patients had fevers during and soon after surgery and were found to have clinical malaria, despite recent treatment. ⋯ Pediatric patients in many areas of the world often present with a high risk for malaria in the perioperative time frame. Treatment with artemisinin-based therapy 3-7 days before elective surgeries may be an effective method to reduce the risks of febrile episodes and clinical malaria during and after surgery in areas of high transmission. However, these results may be limited by (1) the presence of nonfalciparum malarias, some of which may require prolonged treatment for hepatic cryptogenic malaria; (2) the potential for complications related to counterfeit medications; and (3) international efforts at malaria eradication, especially when considering the use of malaria medications that have the potential to develop drug resistance.
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Anesthesia and analgesia · Aug 2019
Development of a Rescue Echocardiography Protocol for Noncardiac Surgery Patients.
Intraoperative transesophageal echocardiography (TEE) is a helpful diagnostic tool when hemodynamic compromise is encountered during noncardiac surgery. At our institution, a Rescue Echo Protocol was created to provide a structured means for requesting and performing a rescue TEE. We analyzed our institutional utilization of this service and found that it was used throughout the spectrum of patients' American Society of Anesthesiologists classifications and surgical services. We demonstrated that 72.9% of rescue examinations resulted in a change in management, supporting the use of TEE as a diagnostic tool during hemodynamic compromise.