British journal of anaesthesia
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Circadian rhythms coordinate almost all physiological functions and are implicated in major disease development. Even though circadian rhythms have a major impact on human health, little is known about how they affect general anaesthesia. The purpose of this study was to understand if the time of day affects the length of time a child needs to achieve readiness for discharge after general anaesthesia for brain MRI. ⋯ The time of day significantly affects PACU recovery times in children of both genders having brain imaging under general anaesthesia. Children younger than 3 yr might not be affected. Further validation of these findings may guide future strategies to reduce discharge times.
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The human p.G2434R variant of the RYR1 gene is most frequently associated with malignant hyperthermia (MH) in the UK. We report the phenotype of a knock-in mouse that expresses the RYR1 variant p.G2435R, which is isogenetic with the human variant. ⋯ RYR1 pG2435R mice demonstrated gene dose-dependent in vitro and in vivo responses to pharmacological and environmental stressors that parallel those seen in patients with the human RYR1 variant p.G2434R.
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Prothrombin complex concentrate (PCC) is increasingly used to correct acquired coagulopathy in trauma and surgery. Dosing of PCC is guided by the prothrombin time, which only reflects the onset of thrombin generation, but does not account for variations in intrinsic pathway coagulation factors, including factor IX (FIX). We hypothesised that FIX contained in PCC could strongly influence thrombin generation patterns. ⋯ FIX derived from PCC strongly enhances tissue factor-triggered thrombin generation in the presence of elevated FVIII activity. Haemodilution further enhances procoagulant effects of FIX and FVIII by slowing down inhibition of procoagulant enzymes. Dosing of PCC per prothrombin time may underestimate PCC's procoagulant potential because it does not account for intrinsic tenase or antithrombin activity.