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Aesthetic Plastic Surgery Jun 2024Sunken eyes have become a most important target of periorbital area aesthetics. Throughout history, the aesthetics of the periorbital region have been emphasized, and...
BACKGROUND
Sunken eyes have become a most important target of periorbital area aesthetics. Throughout history, the aesthetics of the periorbital region have been emphasized, and various surgical techniques related to this region have been described. Most of these techniques provide only soft tissue solutions; therefore, additional surgical interventions may be required. The aim of our study was to introduce an endoscopic supraorbital shaving (SOS) technique for the treatment of individuals with sunken eyes.
METHODS
Between 2020 and 2021, 34 patients (30 females, 4 males; mean age 36.2 years) with sunken eyes were treated with our described technique. All patients underwent an endoscopic SOS procedure under general anesthesia.
RESULTS
A total of 34 patients (30 women and four men), aged 23-59 years old (mean = 36.2 years), underwent the endoscopic SOS procedure. The mean follow-up period was 13 months (range: 12-16 months). Postoperatively, significant improvement in lateral convexity was achieved in all patients. Physical examinations performed at the control visits revealed no functional problems in any patients and no visible or palpable irregularities or contour deformities. No complications were encountered regarding the SOS procedure.
CONCLUSIONS
The technique described here provides significant improvement in lateral convexity compared to other techniques used in patients with sunken eyes. No additional eyelid intervention is needed. Unlike the techniques previously described in the literature, intervention is made in the bone structure, thereby providing more accurate results.
LEVEL OF EVIDENCE V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
PubMed: 38942952
DOI: 10.1007/s00266-024-04194-9 -
Nature Communications Jun 2024Dexamethasone is the standard of care for critically ill patients with COVID-19, but the mechanisms by which it decreases mortality and its immunological effects in this...
Dexamethasone is the standard of care for critically ill patients with COVID-19, but the mechanisms by which it decreases mortality and its immunological effects in this setting are not understood. Here we perform bulk and single-cell RNA sequencing of samples from the lower respiratory tract and blood, and assess plasma cytokine profiling to study the effects of dexamethasone on both systemic and pulmonary immune cell compartments. In blood samples, dexamethasone is associated with decreased expression of genes associated with T cell activation, including TNFSFR4 and IL21R. We also identify decreased expression of several immune pathways, including major histocompatibility complex-II signaling, selectin P ligand signaling, and T cell recruitment by intercellular adhesion molecule and integrin activation, suggesting these are potential mechanisms of the therapeutic benefit of steroids in COVID-19. We identify additional compartment- and cell- specific differences in the effect of dexamethasone that are reproducible in publicly available datasets, including steroid-resistant interferon pathway expression in the respiratory tract, which may be additional therapeutic targets. In summary, we demonstrate compartment-specific effects of dexamethasone in critically ill COVID-19 patients, providing mechanistic insights with potential therapeutic relevance. Our results highlight the importance of studying compartmentalized inflammation in critically ill patients.
Topics: Dexamethasone; Humans; COVID-19 Drug Treatment; COVID-19; SARS-CoV-2; Lung; Cytokines; Critical Illness; Male; Single-Cell Analysis; Female; Middle Aged; T-Lymphocytes; Aged; Lymphocyte Activation
PubMed: 38942804
DOI: 10.1038/s41467-024-49756-2 -
Scientific Reports Jun 2024Self-reported shorter/longer sleep duration, insomnia, and evening preference are associated with hyperglycaemia in observational analyses, with similar observations in...
Self-reported shorter/longer sleep duration, insomnia, and evening preference are associated with hyperglycaemia in observational analyses, with similar observations in small studies using accelerometer-derived sleep traits. Mendelian randomization (MR) studies support an effect of self-reported insomnia, but not others, on glycated haemoglobin (HbA1c). To explore potential effects, we used MR methods to assess effects of accelerometer-derived sleep traits (duration, mid-point least active 5-h, mid-point most active 10-h, sleep fragmentation, and efficiency) on HbA1c/glucose in European adults from the UK Biobank (UKB) (n = 73,797) and the MAGIC consortium (n = 146,806). Cross-trait linkage disequilibrium score regression was applied to determine genetic correlations across accelerometer-derived, self-reported sleep traits, and HbA1c/glucose. We found no causal effect of any accelerometer-derived sleep trait on HbA1c or glucose. Similar MR results for self-reported sleep traits in the UKB sub-sample with accelerometer-derived measures suggested our results were not explained by selection bias. Phenotypic and genetic correlation analyses suggested complex relationships between self-reported and accelerometer-derived traits indicating that they may reflect different types of exposure. These findings suggested accelerometer-derived sleep traits do not affect HbA1c. Accelerometer-derived measures of sleep duration and quality might not simply be 'objective' measures of self-reported sleep duration and insomnia, but rather captured different sleep characteristics.
Topics: Humans; Mendelian Randomization Analysis; Glycated Hemoglobin; Accelerometry; Sleep; Blood Glucose; Male; Female; Middle Aged; Adult; Self Report; Aged; Sleep Initiation and Maintenance Disorders
PubMed: 38942746
DOI: 10.1038/s41598-024-58007-9 -
Journal of Cardiothoracic and Vascular... May 2024The current work was designed to evaluate whether robotic-assisted mitral valve surgery is associated with a different incidence of early postoperative complications...
OBJECTIVE
The current work was designed to evaluate whether robotic-assisted mitral valve surgery is associated with a different incidence of early postoperative complications compared with the traditional minimally invasive approach.
DESIGN
A retrospective monocentric cohort study was conducted.
SETTING
The study was performed in an academic hospital.
PARTICIPANTS
A total of 375 patients who underwent standard thoracoscopic minimally invasive mitral valve surgery and robotic-assisted mitral valve surgery between April 2014 and November 2022 were enrolled.
INTERVENTION
None.
MEASUREMENTS AND MAIN RESULTS
After adjustment using propensity score analysis, 98 patients from each group were identified. Patients who underwent robotic surgery presented a similar rate of early complications to patients undergoing minimally invasive surgery. Nevertheless, they showed shorter intensive care unit and postoperative hospital stays. Finally, patients undergoing robotic-assisted surgery were more frequently discharged home.
CONCLUSIONS
This study identified a similar incidence of early complications in robotic-assisted mitral valve surgery compared with minimally invasive mitral valve surgery; conversely, patients receiving robotic-assisted surgery were discharged earlier, and more frequently discharged home.
PubMed: 38942684
DOI: 10.1053/j.jvca.2024.05.026 -
Regional Anesthesia and Pain Medicine Jun 2024Peer review represents a cornerstone of the scientific process, yet few studies have evaluated its association with scientific impact. The objective of this study is to...
How predictive is peer review for gauging impact? The association between reviewer rating scores, publication status, and article impact measured by citations in a pain subspecialty journal.
BACKGROUND
Peer review represents a cornerstone of the scientific process, yet few studies have evaluated its association with scientific impact. The objective of this study is to assess the association of peer review scores with measures of impact for manuscripts submitted and ultimately published.
METHODS
3173 manuscripts submitted to between August 2018 and October 2021 were analyzed, with those containing an abstract included. Articles were categorized by topic, type, acceptance status, author demographics and open-access status. Articles were scored based on means for the initial peer review where each reviewer's recommendation was assigned a number: 5 for 'accept', 3 for 'minor revision', 2 for 'major revision' and 0 for 'reject'. Articles were further classified by whether any reviewers recommended 'reject'. Rejected articles were analyzed to determine whether they were subsequently published in an indexed journal, and their citations were compared with those of accepted articles when the impact factor was 1.4 points lower than 's 5.1 impact factor. The main outcome measure was the number of Clarivate citations within 2 years from publication. Secondary outcome measures were Google Scholar citations within 2 years and Altmetric score.
RESULTS
422 articles met inclusion criteria for analysis. There was no significant correlation between the number of Clarivate 2-year review citations and reviewer rating score (r=0.038, p=0.47), Google Scholar citations (r=0.053, p=0.31) or Altmetric score (p=0.38). There was no significant difference in 2-year Clarivate citations between accepted (median (IQR) 5 (2-10)) and rejected manuscripts published in journals with impact factors 3.7 (median 5 (2-7); p=0.39). Altmetric score was significantly higher for -published papers compared with -rejected ones (median 10 (5-17) vs 1 (0-2); p<0.001).
CONCLUSIONS
Peer review rating scores were not associated with citations, though the impact of peer review on quality and association with other metrics remains unclear.
PubMed: 38942427
DOI: 10.1136/rapm-2024-105490 -
Regional Anesthesia and Pain Medicine Jun 2024Regional anesthesia (RA) is commonly used in perioperative settings of developed and well-resourced environments. RA has significant potential benefits when used in...
Regional anesthesia (RA) is commonly used in perioperative settings of developed and well-resourced environments. RA has significant potential benefits when used in resource-limited environments, including disaster, mass casualty, and wartime environments. RA offers benefits over general anesthesia and opioid-based analgesia, including decreased risk of complications, decreased reliance on mechanical ventilation, improved cost efficiency, and others. The decreasing cost of ultrasound matched with its smaller size and portability increases the availability of ultrasound in these environments, making ultrasound-guided RA more feasible. This daring discourse discusses some historical examples of RA in ultralow resource environments, both man-made disasters and natural disasters. Future investigations should increase the usefulness and availability of RA in resource-limited environments.
PubMed: 38942425
DOI: 10.1136/rapm-2024-105680 -
Regional Anesthesia and Pain Medicine Jun 2024
PubMed: 38942424
DOI: 10.1136/rapm-2024-105756 -
Heart Rhythm Jun 2024The complexity of cardiac electrophysiology procedures has increased significantly over the past three decades. Anesthesia requirements of these procedures can be... (Review)
Review
The complexity of cardiac electrophysiology procedures has increased significantly over the past three decades. Anesthesia requirements of these procedures can be different based on patient- and procedure-specific factors. This manuscript outlines various anesthesia strategies for cardiac implantable electronic devices and electrophysiology procedures including pre-procedural, procedural and post-procedural management. A team-based approach with collaboration between cardiac electrophysiologists and anesthesiologists is required with careful pre-procedural and intra-procedural planning. Given the recent advances in electrophysiology, there is a need for specialized cardiac electrophysiology anesthesia care to improve the efficacy and safety of the procedures.
PubMed: 38942104
DOI: 10.1016/j.hrthm.2024.06.048 -
Brazilian Journal of Anesthesiology... Jun 2024Preoperative anxiety in children causes negative postoperative outcomes. Parental presence at induction is a non-pharmacological strategy for relieving anxiety;...
BACKGROUND
Preoperative anxiety in children causes negative postoperative outcomes. Parental presence at induction is a non-pharmacological strategy for relieving anxiety; nevertheless, it is not always possible or effective, namely when parents are overly anxious. Parental presence via video has been demonstrated to be useful in other contexts (divorce, criminal court). This study reports the feasibility of a randomized controlled trial to investigate the effect of video parental presence and parental coaching at induction on preoperative anxiety.
METHODS
The study was a randomized, 2 × 2 factorial design trial examining parental presence (virtual vs. physical) and coaching (provided vs. not provided). Feasibility was assessed by enrollment rate, attrition rate, compliance, and staff satisfaction with virtual method with the NASA-Task Load Index (NASA-TLX) and System Usability Scale (SUS). For the children's anxiety and postoperative outcomes, the modified Yale Preoperative Anxiety Scale (mYPAS) and Post-Hospitalization Behavioral Questionnaire (PHBQ) were used. Parental anxiety was evaluated with the State-Trait Anxiety Inventory (STAI) questionnaire.
RESULTS
A total of 41 parent/patient dyads were recruited. The enrollment rate was 32.2%, the attrition rate 25.5%. Compliance was 87.8% for parents and 85% for staff. The SUS was 67.5/100 and 63.5/100 and NASA-TLX was 29.2 (21.5-36.8) and 27.6 (8.2-3.7) for the anesthesiologists and induction nurses, respectively. No statistically significant difference was found in mYPAS, PHBQ and STAI.
CONCLUSION
A randomized controlled trial to explore virtual parental presence effect on preoperative anxiety is feasible. Further studies are needed to investigate its role and the role of parent coaching in reducing preoperative anxiety.
PubMed: 38942079
DOI: 10.1016/j.bjane.2024.844533 -
American Journal of Veterinary Research Jun 2024To evaluate methods for euthanizing cave cockroaches (CCs; Blaberus giganteus) and Madagascar hissing cockroaches (MHCs; Gromphadorhina portentosa). It was hypothesized...
OBJECTIVE
To evaluate methods for euthanizing cave cockroaches (CCs; Blaberus giganteus) and Madagascar hissing cockroaches (MHCs; Gromphadorhina portentosa). It was hypothesized that both suggested methods would be effective for humane mass euthanasia of both species.
SAMPLE
Approximately 800 CC.
METHODS
The CCs were separated into replicate groups of 25, 50, 75, 100, and 150 grams and placed into 3.8-L plastic bags. Twenty-seven MHCs were divided into groups of 2 to 3. The study took place from January to March 2023. All CC groups were exposed to 100% carbon dioxide (CO2) at a rate of 4 L/min until the bag was full. Madagascar hissing cockroaches were similarly anesthetized using either CO2 or 2 mL of isoflurane on a cotton ball in a 1-L container or a combination of CO2 and isoflurane. Once cockroaches were immobile, secondary euthanasia steps were performed. One bag of CCs per weight category was exposed to soapy water (5% Dawn dishwashing liquid), and the second was placed into a -80 °C freezer. The containers of MHCs were evenly exposed to the 2 euthanasia methods. Individuals remained in their secondary euthanasia method for 30 minutes.
RESULTS
Regardless of the weight of the CCs within each bag, there was no impact on time (1.8 ± 0.4 minutes [mean ± SD]) to immobility. The failure rates for both species were 0.2% CI (-0.1% to 1.5% [1/413]) for soapy water and 0.5% CI (0.005% to 1.9% [2/414]) for the freezer method. These results support the use of both 2-step euthanasia methods in CCs and MHCs.
CLINICAL RELEVANCE
These methods will serve as an evidence-based alternative for humane mass euthanasia in cockroaches.
PubMed: 38942060
DOI: 10.2460/ajvr.24.04.0114