Beierstanton7969

Obesity is becoming a frequent condition among obstetric patients. A high body mass index (BMI) has been closely related to a higher difficulty to perform the neuraxial technique and to the failure of epidural analgesia. Our study is aimed at analyzing obese obstetric patients who received neuraxial analgesia for labor at a tertiary hospital and assessing aspects related to the technique and its success.

Retrospective observational descriptive study during one year. Women with a BMI higher than 30 were identified, and variables related to the difficulty and complications of performing the technique, and to analgesia failure rate were assessed.

Out of 3653 patients, 27.4% had their BMI≥30kg.m-². Neuraxial techniques are difficult to be performed in obese obstetric patients, as showed by the number of puncture attempts (≥ 3 in 9.1% obese versus 5.3% in non-obese being p < 0.001), but the incidence of complications, as hematic puncture (6.6%) and accidental dural puncture (0.7%) seems to be similar in both obese and non-obese patients. The incidence of cesarean section in obese patients was 23.4% (p< 0.001). Thus, an early performance of epidural analgesia turns out to be essential to control labor pain and to avoid a general anesthesia in such high-risk patients.

Out of 3653 patients, 27.4% had their BMI ≥ 30 kg.m-². Neuraxial techniques are difficult to be performed in obese obstetric patients, as showed by the number of puncture attempts (≥ 3 in 9.1% obese versus 5.3% in non-obese being p less then 0.001), but the incidence of complications, as hematic puncture (6.6%) and accidental dural puncture (0.7%) seems to be similar in both obese and non-obese patients. The incidence of cesarean section in obese patients was 23.4% (p less then 0.001). Oxaliplatin RNA Synthesis inhibitor Thus, an early performance of epidural analgesia turns out to be essential to control labor pain and to avoid a general anesthesia in such high-risk patients.

This study aimed to analyze the effects of preoperative oral intake of liquid carbohydrate on postoperative blood glucose, fasting-thirst, and fatigue levels in patients undergoing arthroscopic surgery.

This randomized controlled clinical trial enrolled 82 patients, who were scheduled to undergo arthroscopic surgery, and divided them into two groups (1) those who consumed a carbohydrate-rich drink, and (2) those not consuming anything after midnight. Pre- and postoperative fasting-thirst (visual analog scale) and blood glucose levels were measured. Likewise, the Brief Fatigue Inventory was applied to patients 24 hours after surgery.

The mean blood glucose levels in the first postoperative hour were 90.90 ± 13.56 mg.dL

and 107.00 ± 15.84 mg.dL

in the intervention group and control group, respectively (p < 0.001). The postoperative mean thirst scores were 4.70 ± 1.59 and 6.36 ± 2.07 in the intervention group and control group, respectively (p < 0.001). Their corresponding postoperative mean fasting scores were 5.54 ± 1.76 and 5.86 ± 1.79 (p > 0.05) and the mean fatigue levels in the 24

postoperative hour were 4.80 ± 2.13 and 5.48 ± 1.46, respectively (p > 0.05).

Oral intake of liquid carbohydrate before spinal anesthesia was found to have positive effects on patients' postoperative blood glucose and thirst levels.

Oral intake of liquid carbohydrate before spinal anesthesia was found to have positive effects on patients' postoperative blood glucose and thirst levels.

The prevalence of Substance Use Disorders (SUD) and acceptance of drug testing among anesthetists in Brazil has not been determined.

An internet-based survey was performed to investigate the prevalence of SUD among anesthetists in Brazil, to explore the attitudes of anesthetists regarding whether SUD jeopardizes the health of an impaired provider or their patient, and to determine the provider's perspective regarding acceptance and effectiveness of drug testing to reduce SUD. The questionnaire was distributed via social media. REDCap was utilized to capture data. A sample size of 350 to achieve a confidence level of 95% and confidence interval of 5 was estimated. Study report was based on STROBE and CHERRIE statements.

The survey was returned from 1,295 individuals. Most individuals knew an anesthesia provider with a SUD (82.07%), while 23% admitted personal use. The most common identified substances of abuse were opioids (67.05%). Very few respondents worked in a setting that performs drug testing (n=17, 1.33%). Most individuals believed that drug testing could improve personal safety (82.83%) or the safety of patients (85.41%). Individuals with a personal history of SUD were less likely to believe in the effectiveness of drug testing to reduce one's own risk (74.92% vs. 85.18%, p<0.0001) or improve the safety of patients (76.27% vs. 88.13%, p<0.001).

SUDs are common among anesthetists in Brazil. Drug testing would be accepted as a viable means to reduce the incidence although a larger study should be performed to investigate the logistical feasibility.

SUDs are common among anesthetists in Brazil. Drug testing would be accepted as a viable means to reduce the incidence although a larger study should be performed to investigate the logistical feasibility.Chemotactic and angiogenic factors secreted within the tumor microenvironment eventually facilitate the metastatic dissemination of cancer cells. Calcium-sensing receptor (CaSR) activates secretory pathways in breast cancer cells via a mechanism driven by vesicular trafficking of this receptor. However, it remains to be elucidated how endosomal proteins in secretory vesicles are controlled by CaSR. In the present study, we demonstrate that CaSR promotes expression of Rab27B and activates this secretory small GTPase via PI3K, PKA, mTOR and MADD, a guanine nucleotide exchange factor, also known as DENN/Rab3GEP. Active Rab27B leads secretion of various cytokines and chemokines, including IL-6, IL-1β, IL-8, IP-10 and RANTES. Expression of Rab27B is stimulated by CaSR in MDA-MB-231 and MCF-7 breast epithelial cancer cells, but not in non-cancerous MCF-10A cells. This regulatory mechanism also occurs in HeLa and PC3 cells. Our findings provide insightful information regarding how CaSR activates a Rab27B-dependent mechanism to control secretion of factors known to intervene in paracrine communication circuits within the tumor microenvironment.