Articles: cations.
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To explore the clinical utility of circulating tumor DNA (ctDNA) in esophageal adenocarcinoma (EAC) by developing a cost-effective and rapid technique utilising targeted amplicon sequencing. ⋯ Our study shows that ctDNA has potential to provide additional prognostication over conventional staging investigation such as CT and PET. It may also have clinical utility in the assessment of response to NAT and as a biomarker for the surveillance of recurrent disease.
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The transradial approach has increasingly been used for neurointerventions because of the improved safety profile compared with transfemoral. However, it is important to be aware of potential complications such as radial artery (RA) spasm, RA occlusion, pseudoaneurysm, extravasation, arteriovenous fistula, and wrist hematoma as well as their management. ⋯ Transradial access for neurointervention has a low rate of local complications, particularly when taking appropriate prevention measures. Appropriate management of complications can prevent procedural failure and has low morbidity rates demonstrating the overall safety profile of transradial access even when complications occur.
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Case Reports
Retrolaminar Continuous Nerve Block Catheter for Multiple Rib Fractures: A Case Report.
Rib fractures carry high morbidity and mortality due to pain-related complications, such as hypoventilation, atelectasis, and pneumonia. Ultrasound-guided regional anesthesia is a common treatment for pain associated with rib fractures. ⋯ In these instances, it is advantageous to have a tactile or landmark-based approach to treating rib fracture pain. We present a case of a continuous retrolaminar nerve block catheter placed without ultrasound guidance in a 67-year-old man with oxygen-dependent chronic obstructive pulmonary disease and a prior intrathecal pump, who presents with multiple unilateral rib fractures.
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In this issue of Anesthesia & Analgesia, a series of articles focus on the elemental changes to anesthesia training and education. Kealey and Naik review the status of competency-based medical training, a method through which learners are deliberately observed for progression to mastery in clinical management. This is contrast to the assumption that trainees will presumably reach the same intended endpoint merely by spending a pre-specified amount of time in post-graduate residency training. ⋯ They detail the use of virtual and augmented reality to offer trainees the opportunity to engage in clinical exercises that are infrequently encountered in real practice, increase the exposure to challenging scenarios and foster real-time collaborations on a global scale. An accompanying editorial offers further perspective on the future of training in our specialty. The reader is strongly encouraged to review the cited articles for an in-depth appreciation of the concepts discussed.