Comparison of Fentanyl, Ketamine, and Lidocaine Combined with Propofol Anesthesia in Patients with Crohn Disease Undergoing Colonoscopy.

BACKGROUND Colonoscopy is the predominant invasive procedure for Crohn disease (CD) patients. Opioids and propofol carry risks of respiratory and cardiovascular complications. This study aimed to evaluate whether substituting fentanyl with ketamine or lidocaine could diminish propofol usage and minimize adverse events. MATERIAL AND METHODS In total, 146 patients with CD scheduled for elective colonoscopy were assigned to anesthesia with fentanyl (n=47), ketamine (n=47), or lidocaine (n=55). Propofol was administered to achieve sufficient anesthesia. Measured outcomes in each group included propofol consumption, hypotension and desaturation incidents, adverse event types, consciousness recovery time, abdominal pain intensity, Aldrete scale, and Post Anaesthetic Discharge Scoring System (PADSS). RESULTS Patients administered fentanyl needed significantly more propofol (P=0.017) than those on ketamine, with lidocaine showing no notable difference (P=0.28). Desaturation was significantly less common in the ketamine and lidocaine groups than fentanyl group (P<0.001). The ketamine group experienced milder reductions in mean arterial (P=0.018) and systolic blood pressure (P<0.001). Recovery metrics (Aldrete and PADSS scores) were lower for fentanyl (P<0.001), although satisfaction and pain levels were consistent across all groups (P=0.797). Dizziness occurred less frequently with lidocaine than fentanyl (17.2%, P=0.018) and ketamine (15.1%, P=0.019), while metallic taste incidents were more prevalent in the lidocaine group (13.5%, P=0.04) than fentanyl group. CONCLUSIONS Using ketamine or lidocaine instead of fentanyl in anesthesia for colonoscopy in patients with CD significantly lowers propofol use, reduces desaturation events, maintains blood pressure more effectively, without increasing hypotension risk, and accelerates recovery, without negatively impacting adverse events or patient satisfaction.

Ultrasound-Guided Blocks for Spine Surgery: Part 1-Cervix.

Postoperative pain is common following spine surgery, particularly complex procedures. The main anesthetic efforts are focused on applying multimodal analgesia beforehand, and regional anesthesia is a critical component of it. The purpose of this study is to examine the existing techniques for regional anesthesia in cervical spine surgery and to determine their effect and safety on pain reduction and postoperative patient's recovery. The electronic databases were searched for all literature pertaining to cervical nerve block procedures. The following peripheral, cervical nerve blocks were selected and described: paravertebral block, cervical plexus clock, paraspinal interfascial plane blocks such as multifidus cervicis, retrolaminar, inter-semispinal and interfacial, as well as erector spinae plane block and stellate ganglion block. Clinicians should choose more superficial techniques in the cervical region, as they have been shown to be comparably effective and less hazardous compared to paravertebral blocks.

The Level of Fear in the Polish Police Population during the COVID-19 Pandemic with the Impact of Sociodemographic Variables.

This study has a twofold objective. First, we aim to measure the levels of fear among Polish police officers using the COVID-19 Fear Scale (FCV-19S) that has a stable unidimensional structure allowing for the provision of additional data by combining variables. This structure allows the second objective to be met to measure the correlation with sociodemographic variables. The utilitarian objective of the study is to provide information for updating support policies for stress management in the service. The questionnaire was completed by 1862 people with a mean age of 38.75 years with a good Cronbach's alpha (0.89). The perceived level of fear associated with COVID-19 should be considered relatively low. Caring for the elderly does not affect the level of fear. The factors of gender, age and having children statistically significantly differentiate the perceptions of fear. Therefore, there is a necessity to focus on building support for police officers who are over 50 years old, as well as for women, where higher levels of fear in both men and women can translate into the development of psychosomatic illnesses.

Level of Anxiety Caused by the Coronavirus (COVID-19) Pandemic among Dentists in Poland.

Background and Objectives: The early information on both the speed and high morbidity rate and, above all, mortality triggered the symptoms of COVID-19-related panic and anxiety. Dentists were listed in the top five professions with the highest risk of transmission of the virus. The aim of the present study was to investigate the correlation between the fear level of COVID-19 and sociodemographic variables in Polish dentists. Materials and Methods: A cross-sectional study was conducted via an online survey questionnaire with seven statements in the COVID-19 Fear Scale (FCV-19S). The online questionnaire was completed by 356 dentists. The SPSS and PQStat were used to analyze, validate, and assess correlations and logistic regression. Results: In the studied population of dentists, the perceived level of anxiety associated with COVID-19 should be considered relatively low. When the respondents had children, lived with the elderly, or looked after them, the observed level of anxiety was higher, and physical symptoms, such as sweating palms and increased heart rate, occurred. Conclusions: Studies concerning the anxiety level related to COVID-19 carried out among Polish dentists ascertained that the tested level of anxiety among dentists was relatively low. The COVID-19 Fear Scale (FCV-19S) adjusted to the Polish language requirements is a reliable tool that can be used effectively for analyzing the impact of any pandemic on the Polish-speaking population.

Safety of Aesthetic Medicine Procedures in Patients with Autoimmune Thyroid Disease: A Literature Review.

Autoimmune thyroid diseases are the most common organ-specific autoimmune diseases, affecting 2-5% of the world's population. Due to the autoimmune background of thyroid diseases, we analyzed a wide range of cosmetic procedures, from minimally invasive cosmetic injections (mesotherapy) to highly invasive procedures, such as lifting threads. Out of the seven categories of treatments in aesthetic medicine analyzed by us-hyaluronic acid, botulinum toxin, autologous platelet-rich plasma, autologous fat grafting, lifting threads, IPL and laser treatment and mesotherapy-only two, mesotherapy and lifting threads, are not recommended. This is due to the lack of safety studies and the potential possibility of a higher frequency of side effects in patients with autoimmune thyroid diseases.

High pressure-assisted low-loading asymmetric organocatalytic conjugate addition of nitroalkanes to chalcones.

The application of high pressure (up to 9 kbar) allows for relatively fast (1-5 h) and highly enantioselective 1,4-addition of nitromethane and 2-nitropropane to chalcones at room temperature with substantial reduction of catalyst loading (0.2-1 mol% of cinchona alkaloid-based thioureas and squaramides). Various γ-nitroketones were obtained at 9 kbar with high yield and enantioselectivity (up to 98%), whereas in control experiments at atmospheric pressure usually only a small amount (<10%) of products were formed after 20 h.

Polarization gating based on Mueller matrices.

We present mathematical formulas generalizing polarization gating (PG) techniques. PG refers to a collection of imaging methods based on the combination of different controlled polarization channels. In particular, we show how using the measured Mueller matrix (MM) of a sample, a widespread number of PG configurations can be evaluated just from analytical expressions based on the MM coefficients. We also show the interest of controlling the helicity of the states of polarization used for PG-based metrology, as this parameter has an impact in the image contrast of samples. In addition, we highlight the interest of combining PG techniques with tools of data analysis related to the MM formalism, such as the well-known MM decompositions. The method discussed in this work is illustrated with the results of polarimetric measurements done on artificial phantoms and real ex-vivo tissues.