British journal of anaesthesia
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Randomized Controlled Trial
Opioids and premature biochemical recurrence of prostate cancer: a randomised prospective clinical trial.
Prostate cancer is one of the most prevalent neoplasms in male patients, and surgery is the main treatment. Opioids can have immune modulating effects, but their relation to cancer recurrence is unclear. We evaluated whether opioids used during prostatectomy can affect biochemical recurrence-free survival. ⋯ NCT03212456.
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Novel preventive therapies are needed for postoperative delirium, which especially affects older patients. A mouse model is presented that captures inflammation-associated cortical slow wave activity (SWA) observed in patients, allowing exploration of the mechanistic role of prostaglandin-adenosine signalling. ⋯ Cytokine-SWA correlations during wakefulness are consistent with observations in patients with delirium. Absence of connectivity effects after accounting for movement changes suggests decreased connectivity in patients is a biomarker of hypoactivity. Exaggerated effects in quiescent aged animals are consistent with increased hypoactive delirium in older patients. Prostaglandin-adenosine signalling may link inflammation to neural changes and hence delirium.
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Comparative Study Observational Study
Inhalation or total intravenous anaesthesia and recurrence after colorectal cancer surgery: a propensity score matched Danish registry-based study.
During colorectal cancer surgery, the immune-modulating effects of inhalation anaesthesia may create a favourable environment for metastasis formation, leading to increased risk of recurrence. Our aim was to assess the association between inhalation vs intravenous anaesthesia and cancer recurrence in patients undergoing colorectal cancer surgery. ⋯ Exposure to inhalation anaesthesia was associated with increased risk of recurrence after colorectal cancer surgery.