Prevalence of allergic sensitization to Platanus occidentalis among adults with allergic rhinitis: A multicenter study.

Background: In the Americas there are few studies that have evaluated the frequency of allergic sensitization to Platanus occidentalis or sycamore pollen in adult patients with allergic rhinitis (AR). Objective: To determine the prevalence of allergic sensitization to P. occidentalis and to identify factors associated with its presentation. Methods: A cross-sectional study was carried out in 3 centers distributed in the northwest, west, and southeast of Mexico. Allergic sensitization to P. occidentalis was determined with a skin prick test. Prevalence and 95% confidence intervals (CI) were estimated. Results: A total of 404 patients were included, women were 233 (57.7%); the age mean was 33.8 ± 12.9 years. The overall prevalence of sensitization to P. occidentalis was 20.8% (95% CI, 17.1%-25.0%); in the northwestern: 15.9% (95% CI, 9.6%-25.1%); in the western: 21.8% (95% CI, 15.4%-29.9%); and in the southeastern: 22.4% (95% CI, 17.1%-38.8%). Multivariate analysis showed to the following allergens as factors associated with sycamore allergic sensitization: tree pollens (OR, 3.19; P = 0.001), weeds (OR, 2.49; P = 0.004), fungi (OR, 1.96; P = 0.014), and dog or cat epitheliums (OR, 1.88; P = 0.018). Conclusion: Allergic sensitization to P. occidentalis pollen in AR patients is not an infrequent event; consequently, we recommend doing the challenge test in all patients with this allergen, especially in those regions where the tree is present.

Causes of Death Among Medical ICU Patients With Pneumonia Due to COVID-19 in a Safety-Net Hospital.

We sought to identify the primary causes of death of adult patients admitted to the medical ICU with symptomatic COVID-19 who ultimately suffered in-hospital mortality over the span of three major waves of COVID-19: Wild-type, alpha/epsilon, and delta. DESIGN: Retrospective single-center cohort study from March 2020 to December 2021. SETTING: One medical ICU in a 600-bed Tertiary Care Hospital in Los Angeles, CA. PATIENTS: Adult (n = 306) ICU patients admitted with symptomatic COVID-19 who suffered in-hospital mortality. INTERVENTIONS: None. MAIN RESULTS: Of the 306 patients with COVID-19 who died in the hospital, 86.3% were Hispanic/Latino. The leading cause of death was respiratory failure, occurring in 57.8% of patients. There was no significant change in the rate of pulmonary deaths across the three waves of COVID-19 in our study period. The mean time from symptom onset to admission was 6.5 days, with an average hospital length of stay of 18 days. This did not differ between pulmonary and other causes of death. Sepsis was the second most common cause of death at 23.9% with a significant decrease from the wild-type wave to the delta wave. Among patients with sepsis as the cause of death, 22% (n = 16) were associated with fungemia. There was no significant association between steroid administration and cause of death. Lastly, the alpha/epsilon wave from December 2020 to May 2021 had the highest mortality rate when compared with wild-type or delta waves. CONCLUSIONS: We found the primary cause of death in ICU patients with COVID-19 was acute respiratory failure, without significant changes over the span of three waves of COVID-19. This finding contrasts with reported causes of death for patients with non-COVID-19 acute respiratory distress syndrome, in which respiratory failure is an uncommon cause of death. In addition, we identified a subset of patients (5%) who died primarily due to fungemia, providing an area for further investigation.

Neural representations of vicarious rewards are linked to interoception and prosocial behaviour.

Every day we constantly observe other people receiving rewards. Theoretical accounts posit that vicarious reward processing might be linked to people's sensitivity to internal body states (interoception) and facilitates a tendency to act prosocially. However, the neural processes underlying the links between vicarious reward processing, interoception, and prosocial behaviour are poorly understood. Previous research has linked vicarious reward processing to the anterior cingulate gyrus (ACCg) and the anterior insula (AI). Can we predict someone's propensity to be prosocial or to be aware of interoceptive signals from variability in how the ACCg and AI process rewards? Here, participants monitored rewards being delivered to themselves or a stranger during functional magnetic resonance imaging. Later, they performed a task measuring their willingness to exert effort to obtain rewards for others, and a task measuring their propensity to be aware and use interoceptive respiratory signals. Using multivariate similarity analysis, we show that people's willingness to be prosocial is predicted by greater similarity between self and other representations in the ACCg. Moreover, greater dissimilarity in self-other representations in the AI is linked to interoceptive propensity. These findings highlight that vicarious reward is linked to bodily signals in AI, and foster prosocial tendencies through the ACCg.

Focal Therapy of Prostate Cancer Index Lesion With Irreversible Electroporation. A Prospective Study With a Median Follow-up of 3 Years.

PURPOSE: Our aim was to assess oncologic, safety, and quality of life-related outcomes of focal therapy with irreversible electroporation in men with localized prostate cancer. MATERIALS AND METHODS: This was a single-center, phase II study. INCLUSION CRITERIA: prostate cancer International Society of Urological Pathology grade 1-2, prostate specific antigen ≤15 ng/ml, ≤cT2b. Patients were selected based on multiparametric magnetic resonance imaging and transperineal systematic and targeted magnetic resonance imaging-ultrasound fusion-guided biopsy. Ablation of index lesions with safety margin was performed. Primary end point was cancer control, defined as the absence of any biopsy-proven tumor. A control transperineal biopsy was planned at 12 months and when suspected based on prostate specific antigen and/or multiparametric magnetic resonance imaging information. Quality of life was assessed using Expanded Prostate Cancer Index Composite Urinary Continence domain, International Index of Erectile Function, and International Prostate Symptom Score. RESULTS: From November 2014 to July 2021, 41 consecutive patients were included with a median follow-up of 36 months. Thirty patients (73%) had International Society of Urological Pathology grade 1 tumors, 10 (24%) grade 2, and 1 (2.4%) grade 3. Recurrence was observed in 16 of 41 (39%) of the whole cohort, and 16 of 33 (48.4%) who underwent biopsy. In-field recurrence was detected in 5 (15%) and out-of-field in 11 (33.3%). Ten of 41 (24.6%) including 3 of 5 (60%) with in-field recurrences had significant tumors (Gleason pattern 4-5; more than 1 core or any >5 mm involved). Median recurrence-free survival was 32 months (95% CI 6.7-57.2). Twenty-six patients (63.4%) were free from salvage treatment. All patients preserved urinary continence. Potency was maintained in 91.8%. CONCLUSIONS: Irreversible electroporation can achieve satisfactory 3-year in-field tumor control with excellent quality of life results in selected patients.

Neural and Cognitive Signatures of Guilt Predict Hypocritical Blame.

A common form of moral hypocrisy occurs when people blame others for moral violations that they themselves commit. It is assumed that hypocritical blamers act in this manner to falsely signal that they hold moral standards that they do not really accept. We tested this assumption by investigating the neurocognitive processes of hypocritical blamers during moral decision-making. Participants (62 adult UK residents; 27 males) underwent functional MRI scanning while deciding whether to profit by inflicting pain on others and then judged the blameworthiness of others' identical decisions. Observers (188 adult U.S. residents; 125 males) judged participants who blamed others for making the same harmful choice to be hypocritical, immoral, and untrustworthy. However, analyzing hypocritical blamers' behaviors and neural responses shows that hypocritical blame was positively correlated with conflicted feelings, neural responses to moral standards, and guilt-related neural responses. These findings demonstrate that hypocritical blamers may hold the moral standards that they apply to others.

Prosocial behavior is associated with transdiagnostic markers of affective sensitivity in multiple domains.

Prosocial behaviors-actions that benefit others-fundamentally shape our interpersonal interactions. Psychiatric disorders have been suggested to be related to prosocial disturbances, which may underlie many of their social impairments. However, broader affective traits, present to different degrees in both psychiatric and healthy populations, also have been linked to variability in prosociality. Therefore, it is unclear to what extent prosocial variability is explained by specific psychiatric disorders relative to broad affective traits. Using a computational, transdiagnostic approach in two online studies, we found that participants who reported being more affectively reactive across a broad cluster of traits manifested greater frequencies of prosocial actions in two different contexts: They reported being more averse to harming others for profit, and they were more willing to exert effort to benefit others. These findings help illuminate the profile of prosociality across psychiatric conditions as well as the architecture of prosocial behavior in healthy individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Educational level and positive serology for dengue. a knowledge, attitudes and practices study in Huánuco, Peru

Dengue is a worldwide spread arboviral disease. Huánuco region is an endemic area for dengue. Understanding the influence of Knowledge, Attitudes and Practices (KAP) in dengue endemic areas can provide important insight for improving public health policies. The purpose of this study was to understand the KAP about dengue in the marginal urban city of Tingo Maria, district of Rupa-Rupa, a rain forest area in Huánuco region and its association with positive serology for dengue. An analytical, retrospective, cross-sectional study was carried out in which a randomized sample of 112 people were evaluated using a semi structured questionnaire and tested for IgG against dengue virus. Most participants recruited were from marginal urban settlements. The median age was 38 years and 64% were female. A bivariate analysis showed an association between educational level and serological positivity. Over 95% of participants with only primary school education had a positive serological test for dengue. No statistical significances were found between attitudes towards dengue control initiatives (p=0.221), preventive practices against dengue (p=0.773), and the level of knowledge about dengue (p=0.073). Although attitudes, preventive practices and level of knowledge were not related to positive serology in dengue cases, educational level showed an association with serological positivity for dengue.

Blastocystis species and Gastrointestinal Symptoms in Peruvian Adults Attended in a Public Hospital.

The objective of this study was to evaluate the role of Blastocystis sp. in gastrointestinal symptoms reported by adult patients in a Peruvian hospital. A case-control 3:1 study was performed at the outpatient clinic. Direct stool examinations were done. One hundred sixty patients were included, 40 cases and 120 controls. Positivity to Blastocystis sp. was associated with dyspepsia (P <0.001), bloating (P <0.001) and abdominal pain (P = 0.03) in patients attending our hospital outpatient clinic.

Fungal-Induced Programmed Cell Death.

Fungal infections are a cause of morbidity in humans, and despite the availability of a range of antifungal treatments, the mortality rate remains unacceptably high. Although our knowledge of the interactions between pathogenic fungi and the host continues to grow, further research is still required to fully understand the mechanism underpinning fungal pathogenicity, which may provide new insights for the treatment of fungal disease. There is great interest regarding how microbes induce programmed cell death and what this means in terms of the immune response and resolution of infection as well as microbe-specific mechanisms that influence cell death pathways to aid in their survival and continued infection. Here, we discuss how programmed cell death is induced by fungi that commonly cause opportunistic infections, including Candida albicans, Aspergillus fumigatus, and Cryptococcus neoformans, the role of programmed cell death in fungal immunity, and how fungi manipulate these pathways.

Establishing a Cohort and a Biorepository to Identify Biomarkers for Early Detection of Lung Cancer: The Nashville Lung Cancer Screening Trial Cohort.

Rationale: A prospective longitudinal cohort of individuals at high risk of developing lung cancer was established to build a biorepository of carefully annotated biological specimens and low-dose computed tomography (LDCT) chest images for derivation and validation of candidate biomarkers for early detection of lung cancer.Objectives: The goal of this study is to characterize individuals with high risk for lung cancer, accumulating valuable biospecimens and LDCT chest scans longitudinally over 5 years.Methods: Participants 55-80 years of age with a 5-year estimated risk of developing lung cancer >1.5% were recruited and enrolled from clinics at the Vanderbilt University Medical Center, Veteran Affairs Medical Center, and Meharry Medical Center. Individual demographic characteristics were assessed via questionnaire at baseline. Participants underwent an LDCT scan, spirometry, sputum cytology, and research bronchoscopy at the time of enrollment. Participants will be followed yearly for 5 years. Positive LDCT scans are followed-up according to standard of care. The clinical, imaging, and biospecimen data are collected prospectively and stored in a biorepository. Participants are offered smoking cessation counseling at each study visit.Results: A total of 480 participants were enrolled at study baseline and consented to sharing their data and biospecimens for research. Participants are followed with yearly clinic visits to collect imaging data and biospecimens. To date, a total of 19 cancers (13 adenocarcinomas, four squamous cell carcinomas, one large cell neuroendocrine, and one small-cell lung cancer) have been identified.Conclusions: We established a unique prospective cohort of individuals at high risk for lung cancer, enrolled at three institutions, for whom full clinical data, well-annotated LDCT scans, and biospecimens are being collected longitudinally. This repository will allow for the derivation and independent validation of clinical, imaging, and molecular biomarkers of risk for diagnosis of lung cancer.Clinical trial registered with ClinicalTrials.gov (NCT01475500).

Effort shapes social cognition and behaviour: A neuro-cognitive framework.

Theoretical accounts typically posit that variability in social behaviour is a function of capacity limits. We argue that many social behaviours are goal-directed and effortful, and thus variability is not just a function of capacity, but also motivation. Leveraging recent work examining the cognitive, computational and neural basis of effort processing, we put forward a framework for motivated social cognition. We argue that social cognition is demanding, people avoid its effort costs, and a core-circuit of brain areas that guides effort-based decisions in non-social situations may similarly evaluate whether social behaviours are worth the effort. Thus, effort sensitivity dissociates capacity limits from social motivation, and may be a driver of individual differences and pathological impairments in social cognition.

Six-minute walk distance in healthy young adults.

BACKGROUND: The 6-min walk test (6MWT) is a commonly used clinical assessment of exercise capacity in patients with cardiopulmonary or neuromuscular disease, but normal values are lacking for young adults, who are frequent subjects of testing. METHODS: In a two-center study, 272 young adults, ages 18-50, underwent American Thoracic Society protocolized 6-min walk testing, and 56 underwent repeat testing. A linear regression model was developed based on anthropomorphic data. This model was compared to existing prediction equations. RESULTS: Median 6MWD for the cohort was 637 m (IQR 584-686 m) and was not significantly impacted by age. This is in contrast to existing equations extrapolated from older subjects that predict increasing 6MWD in younger subjects. We found weak correlation of 6MWD with height, weight, BMI, and resting heart rate. Heart rate at completion correlated most strongly with 6MWD (rho 0.53 p < 0.0001). Repeat 6MWD was surprisingly variable, with a median difference between tests of 32.5 ± 31.9 m. Established reference equations performed poorly in this population, largely because age has much less effect on 6MWD in this group than in older adults. CONCLUSIONS: Established reference equations should be reconfigured to include data from young adults, as age has minimal effect on 6MWD in this population. Heart rate response may be a valuable measure of effort in normal subjects. Six-minute walk distance, as with pulmonary function and exercise testing, should have predictive equations across the spectrum of age to allow for accurate assessment of exercise limitation.

Aplicación móvil para el análisis de la experiencia quirúrgica / Mobile application to analyse surgical experience

OBJETIVO: Cuantificar la experiencia quirúrgica obtenida por los residentes del programa de especialización en neurocirugía durante un periodo de 6 meses. MATERIAL Y MÉTODO: Un total de 13 residentes se registraron en el programa de especialización en neurocirugía en el periodo de febrero a julio de 2018. Durante este periodo se documentaron en el Registro Neuroquirúrgico Electrónico los procedimientos en los que cada residente participó y el rol que desempeñó. Los residentes que se retiraron del programa fueron excluidos. RESULTADOS: Se realizaron 530 procedimientos en el periodo de estudio. El aprendizaje por observación y la práctica tutelada se realizan principalmente en el primer y quinto año de residencia, periodos durante los cuales el residente comienza su aprendizaje en el área cirugías de urgencias y electivas, respectivamente. Posteriormente es capaz de realizar cirugías de manera autónoma, en el bloque de urgencias, durante el segundo y tercer año; y en el bloque de cirugías electivas, en el sexto año. El residente es capaz de instruir a cirujanos menos experimentados en el cuarto año. CONCLUSIONES: El Registro Neuroquirúrgico Electrónico es una herramienta tecnológica innovadora que apoya en los campos de asistencia, docencia e investigación. Permite conocer con exactitud la cantidad de pacientes que han sido intervenidos quirúrgicamente en un determinado momento, lo cual brinda información valiosa para el manejo adecuado de recursos. Los datos obtenidos permiten identificar áreas de oportunidad en el entrenamiento de los residentes, lo que permite el desarrollo de estrategias para la mejora continua en la formación de neurocirujanos competentes

OBJECTIVE: To quantify the surgical experience acquired by residents in the neurosurgery specialisation programme over a 6-month period. MATERIALS AND METHODS: A total of 13 residents enrolled in the neurosurgery specialisation programme from February 2018 to July 2018. Over this period, the procedures residents were involved in and the role they played were documented in the Electronic Neurosurgical Register. Residents who withdrew from the specialisation program were excluded. RESULTS: A total of 530 procedures were performed during the study period. Observational learning and supervised practice are conducted primarily in the first and fifth years of residence, during which residents begin their training in emergency and elective surgeries, respectively. Residents are then able to independently perform emergency surgeries during the second and third years, and elective surgeries in the sixth year. Residents are able to instruct less experienced surgeons in the fourth year. CONCLUSIONS: The Electronic Neurosurgical Register is an innovative technological tool that supports the fields of care, teaching and research. It records the exact number of patients who have undergone surgery at a particular time, providing valuable information for the proper management of resources. The data obtained can be used to identify areas of opportunity in the training of residents, facilitating the development of continuous improvement strategies in the training of competent neurosurgeons

[The prevalence of oral allergy syndrome: regarding a new classification]. / Prevalencia del síndrome de alergia oral: a propósito de una nueva clasificación.

BACKGROUND: Recently, the oral allergy syndrome (OAS) has been classified according to the foods that induce it: phenotype I, when it is caused only by plant-derived foods; phenotype II, when it is caused by foods of both animal and plant origin. OBJECTIVE: To determine the prevalence of OAS in late teenagers according to the new classification. METHODS: A cross-sectional study in which data from 1,992 teenagers, aged 15-18 year-old, was analyzed; the information was obtained through a structured questionnaire, where questions were asked about oral symptoms according to the type of food that had been ingested. RESULTS: The overall prevalence of OAS was of 1.7% (95% CI = 1.2-2.4); for phenotype I, it was of 0.85% and, for phenotype II, it was of 0.85%. According to the phenotype, there was no difference by sex and personal history of atopic disease; instead, the onset time of the symptoms did show an association with the phenotype (p = 0.048). The frequency of skin and mucosal symptoms and respiratory ailments differed between the groups. Regarding gastrointestinal symptoms, diarrhea was markedly more frequent in phenotype II (p = 0.044). CONCLUSION: Two phenotypes with OAS were clearly identified: the first one was associated exclusively to foods of plant origin, and the other was related to foods of both plant and animal origin.

Antecedentes: Recientemente, el síndrome de alergia oral (SAO) ha sido clasificado de acuerdo con los alimentos que lo inducen: fenotipo I, relacionado con alimentos derivados de plantas; fenotipo II, provocado por alimentos de origen vegetal y animal. Objetivo: Determinar la prevalencia del síndrome de alergia oral en adolescentes tardíos según la nueva clasificación. Métodos: Estudio transversal en el que se analizaron los datos de 1992 adolescentes de 15 a 18 años; la información se obtuvo a través de un cuestionario estructurado, en el que se interrogó acerca de síntomas orales según el tipo de alimento consumido. Resultados: La prevalencia global de síndrome de alergia oral fue de 1.7 % (IC 95 % = 1.2-2.4): fenotipo I, 0.85 % y fenotipo II, 0.85 %. Según el fenotipo no hubo diferencia por sexo e historia personal de enfermedad atópica; el tiempo de inicio de los síntomas sí mostró asociación (p = 0.048). La frecuencia de los síntomas respiratorios, en piel y mucosas no difirieron entre los grupos; respecto a los síntomas gastrointestinales, la diarrea fue notoriamente más frecuente en el fenotipo II (p = 0.044). Conclusión: Se identificaron claramente los dos fenotipos del síndrome de alergia oral: uno asociado con alimentos de origen vegetal y otro a alimentos tanto de origen vegetal como animal.

Mobile application to analyse surgical experience. / Aplicación móvil para el análisis de la experiencia quirúrgica.

OBJECTIVE: To quantify the surgical experience acquired by residents in the neurosurgery specialisation programme over a 6-month period. MATERIALS AND METHODS: A total of 13 residents enrolled in the neurosurgery specialisation programme from February 2018 to July 2018. Over this period, the procedures residents were involved in and the role they played were documented in the Electronic Neurosurgical Register. Residents who withdrew from the specialisation program were excluded. RESULTS: A total of 530 procedures were performed during the study period. Observational learning and supervised practice are conducted primarily in the first and fifth years of residence, during which residents begin their training in emergency and elective surgeries, respectively. Residents are then able to independently perform emergency surgeries during the second and third years, and elective surgeries in the sixth year. Residents are able to instruct less experienced surgeons in the fourth year. CONCLUSIONS: The Electronic Neurosurgical Register is an innovative technological tool that supports the fields of care, teaching and research. It records the exact number of patients who have undergone surgery at a particular time, providing valuable information for the proper management of resources. The data obtained can be used to identify areas of opportunity in the training of residents, facilitating the development of continuous improvement strategies in the training of competent neurosurgeons.

Effect of intraoperative paravertebral or intravenous lidocaine versus control during lung resection surgery on postoperative complications: A randomized controlled trial.

BACKGROUND: Use of minimally invasive surgical techniques for lung resection surgery (LRS), such as video-assisted thoracoscopy (VATS), has increased in recent years. However, there is little information about the best anesthetic technique in this context. This surgical approach is associated with a lower intensity of postoperative pain, and its use has been proposed in programs for enhanced recovery after surgery (ERAS). This study compares the severity of postoperative complications in patients undergoing LRS who have received lidocaine intraoperatively either intravenously or via paravertebral administration versus saline. METHODS/DESIGN: We will conduct a single-center randomized controlled trial involving 153 patients undergoing LRS through a thoracoscopic approach. The patients will be randomly assigned to one of the following study groups: intravenous lidocaine with more paravertebral thoracic (PVT) saline, PVT lidocaine with more intravenous saline, or intravenous remifentanil with more PVT saline. The primary outcome will be the comparison of the postoperative course through Clavien-Dindo classification. Furthermore, we will compare the perioperative pulmonary and systemic inflammatory response by monitoring biomarkers in the bronchoalveolar lavage fluid and blood, as well as postoperative analgesic consumption between the three groups of patients. We will use an ANOVA to compare quantitative variables and a chi-squared test to compare qualitative variables. DISCUSSION: The development of less invasive surgical techniques means that anesthesiologists must adapt their perioperative management protocols and look for anesthetic techniques that provide good analgesic quality and allow rapid rehabilitation of the patient, as proposed in the ERAS protocols. The administration of a continuous infusion of intravenous lidocaine has proven to be useful and safe for the management of other types of surgery, as demonstrated in colorectal cancer. We want to know whether the continuous administration of lidocaine by a paravertebral route can be substituted with the intravenous administration of this local anesthetic in a safe and effective way while avoiding the risks inherent in the use of regional anesthetic techniques. In this way, this technique could be used in a safe and effective way in ERAS programs for pulmonary resection. TRIAL REGISTRATION: EudraCT, 2016-004271-52; ClinicalTrials.gov, NCT03905837 . Protocol number IGGFGG-2016 version 4.0, 27th April 2017.

Pathologic Difference between Sepsis and Bloodstream Infections.

BACKGROUND: Sepsis, defined as life-threatening organ failure caused by a dysregulated host response to infection, is a major cause of morbidity and mortality in hospitalized patients. Understanding the features that distinguish sepsis from bloodstream infections (and other types of infection) can help clinicians appropriately and efficiently target their diagnostic workup and therapeutic interventions, especially early in the disease course. CONTENT: In this review, sepsis and bloodstream infections are both defined, with a focus on recent changes in the sepsis definition. The molecular and cellular pathways involved in sepsis pathogenesis are described, including cytokines, the coagulation cascade, apoptosis, and mitochondrial dysfunction. Laboratory tests that have been evaluated for their utility in sepsis diagnosis are discussed. SUMMARY: Sepsis is defined not only by the presence of an infection, but also by organ dysfunction from a dysregulated host response to that infection. Numerous pathways, including proinflammatory and antiinflammatory cytokines, the coagulation cascade, apoptosis, and mitochondrial dysfunction, help determine if a bloodstream infection (or any other infection) progresses to sepsis. Many biomarkers, including C-reactive protein, procalcitonin, and lactic acid have been evaluated for use in sepsis diagnosis, although none are routinely recommended for that purpose in current clinical practice. While some laboratory tests can help distinguish the 2, the presence of organ dysfunction is what separates sepsis from routine infections.

Effects of Intraoperative Infusion of Esmolol on Systemic and Pulmonary Inflammation in a Porcine Experimental Model of Lung Resection Surgery.

BACKGROUND: Lung resection surgery (LRS) is associated with systemic and pulmonary inflammation, which can affect postoperative outcomes. Activation of ß-adrenergic receptors increases the expression of proinflammatory and anti-inflammatory mediators, and their blockade may attenuate the systemic inflammatory response. The aim of this study was to analyze the effect of a continuous perioperative intravenous perfusion of esmolol on postoperative pulmonary edema in an experimental model of LRS requiring periods of one-lung ventilation (OLV). METHODS: Twenty-four large white pigs were randomly assigned to 3 groups: control (CON), esmolol (ESM), and sham. The ESM group received an intravenous esmolol bolus (0.5 mg/kg) and then an esmolol infusion (0.05 mg·kg·minute) throughout the procedure. The CON group received the same volume of 0.9% saline solution as the ESM group plus a continual infusion of saline. The sham group underwent a left thoracotomy without LRS or OLV. At the end of the LRS, the animals were awakened, and after 24 hours, they underwent general anesthesia again. Lung biopsies and plasma samples were obtained to analyze the levels and expression of inflammatory mediators, and the animals also received a bronchoalveolar lavage. RESULTS: At 24 hours after the operation, the ESM group had less lung edema and lower expression of the proinflammatory biomarkers tumor necrosis factor (TNF) and interleukin (IL)-1 compared to the CON group for both lung lobes. For the mediastinal lobe biopsies, the mean difference and 95% confidence interval (CI) between the groups for edema, TNF, and IL-1 were 14.3 (95% CI, 5.6-23.1), P = .002; 0.19 (95% CI, 0.07-0.32), P = .002; and 0.13 (95% CI, 0.04-0.22), P = .006, respectively. In the left upper lobe, the mean differences for edema, TNF, and IL-1 were 12.4 (95% CI, 4.2-20.6), P = .003; 0.25 (95% CI, 0.12-0.37), P < .001; and 0.3 (95% CI, 0.08-0.53), P = .009. CONCLUSIONS: Our results suggest that esmolol reduces lung edema and inflammatory responses in the intraoperative and postoperative periods in animals that underwent LRS with OLV.