Articles: cations.
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Sepsis and trauma remain the leading causes of morbidity and mortality. Our understanding of the molecular pathogenesis in the development of multiple organ dysfunction in sepsis and trauma has evolved as more focus is on secondary injury from innate immunity, inflammation, and the potential role of endogenous danger molecules. Studies of the past several decades have generated evidence for extracellular RNAs (exRNAs) as biologically active mediators in health and disease. Here, we review studies on plasma exRNA profiling in mice and humans with sepsis and trauma, the role and mode of action by exRNAs, such as ex-micro(mi)RNAs, in host innate immune response, and their potential implications in various organ injury during sepsis and trauma.
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Acta Anaesthesiol Scand · Feb 2023
Observational StudyIssuing of isotonic crystalloid solutions to Danish public hospitals in 2021 - a retrospective nationwide observational study.
Intravenous (IV) fluid therapy is a ubiquitous intervention in daily clinical practice. However, nationwide detailed hospital- and departmental-level information on IV fluid use is limited. Hence, we aimed to describe the current issuing of isotonic crystalloid solutions across Danish public hospitals. ⋯ IV fluid administration practices can be assessed across specialties by examining hospital purchasing. This study analysed the use of IV isotonic crystalloid solutions across all major departments of Danish public hospitals for 1 year. Isotonic sodium chloride was the most commonly used fluid in emergency medicine (71%), internal medicine (85%) and surgical departments (71%). Only anaesthesia and intensive care medicine departments used more buffered crystalloid solutions (57%) than isotonic natrium chloride.
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Flow diverters coated with antithrombogenic substances were recently introduced and have shown encouraging results in the preclinical setting. Our aim was to analyze their clinical application in patients with ruptured intracranial aneurysms using single antiplatelet therapy (SAPT). ⋯ Flow diversion for ruptured aneurysms under SAPT with coated stents is feasible. Although the risk of hemorrhagic complications was low, thromboembolic complications occurred in a significant number of patients, all under ASA SAPT.
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Anesthesia and analgesia · Feb 2023
Randomized Controlled TrialEffect of 5% EMLA Cream on Postoperative Sore Throat in Adults Following General Endotracheal Anesthesia: A Randomized Placebo-Controlled Study.
Postoperative sore throat (POST) is a distressing complaint in adults after endotracheal intubation. This study aimed to evaluate the effect of topical application of a eutectic mixture of local anesthetics (EMLA) cream over the endotracheal tube (ETT) cuff on the incidence and severity of POST, cough, and hoarseness of voice in adults after surgery. ⋯ The application of EMLA cream over ETT cuff reduces the incidence and severity of POST, cough, and hoarseness of voice in adults after general anesthesia in the early postoperative period compared to lubricant gel.
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Anesthesia and analgesia · Feb 2023
ReviewResident Physicians as Clinical Educators in Anesthesiology: A Narrative Review.
The importance of resident physicians as clinical educators is widely acknowledged in many clinical specialties and by national accreditation organizations for medical education. Within anesthesiology training programs, there is growing attention to the role of trainees as clinical educators. This narrative review describes the theoretical and demonstrated benefits of clinical teaching by residents in anesthesiology and other medical fields, summarizes current efforts to support and promote residents as educators, and suggests ways in which anesthesiology training programs can further assess and develop the role of residents as clinical educators.