The leptin-signaling pathway and other genes involved in energy homeostasis (EH) have been examined in relation to breast cancer risk as well as to obesity. We test the hypothesis that genetic variation in EH genes influences survival after diagnosis with breast cancer and that body mass index (BMI) will modify that risk.
 We evaluated associations between 10 EH genes and survival among 1,186 non-Hispanic white and 1,155 Hispanic/Native American women diagnosed with breast cancer. Percent Native American (NA) ancestry was determined from 104 ancestry-informative markers. Adaptive rank truncation product (ARTP) was used to determine gene and pathway significance. The overall EH pathway was marginally significant for all-cause mortality among women with low NA ancestry (P
 ARTP = 0.057). Within the pathway, ghrelin (GHRL) and leptin receptor (LEPR) were significantly associated with all-cause mortality (P
 ARTP = 0.035 and 0.007, respectively). The EH pathway was significantly associated with breast cancer-specific mortality among women with low NA ancestry (P
 ARTP = 0.038). Three genes cholecystokinin (CCK), GHRL, and LEPR were significantly associated with breast cancer-specific mortality among women with low NA ancestry (P
 ARTP = 0.046, 0.015, and 0.046, respectively), while neuropeptide Y (NPY) was significantly associated with breast cancer-specific mortality among women with higher NA ancestry (P
 ARTP = 0.038). BMI did not modify these associations. Our data support our hypothesis that certain EH genes influence survival after diagnosis with breast cancer; associations appear to be most important among women with low NA ancestry.

/pdf/energy-homeostasis-genes-and-survival-after-breast-cancer-17irhd459f.pdf

Energy homeostasis genes and survival after breast cancer diagnosis: the Breast Cancer Health Disparities Study

Despite the excellent properties of silicone endotracheal prostheses, their main limitation is the formation of a polymicrobial biofilm on their surfaces. It can cause local inflammation, interfering with the local healing process and leading to further complications in the clinical scenario. The present study evaluated the inhibitory effect of cold atmospheric plasma (CAP) on multispecies biofilms grown on the silicone protheses’ surfaces. In addition to silicone characterization before and after CAP exposure, CAP cytotoxicity on immortalized human bronchial epithelium cell line (BEAS-2B) was evaluated. The aging time test reported that CAP could temporarily change the silicone surface wetting characteristics from hydrophilic (80.5°) to highly hydrophilic (<5°). ATR-FTIR showed no significant alterations in the silicone surficial chemical composition after CAP exposure for 5 min. A significant log reduction in viable cells in monospecies biofilms (log CFU/mL) of C. albicans, S. aureus, and P. aeruginosa (0.636, 0.738, and 1.445, respectively) was detected after CAP exposure. Multispecies biofilms exposed to CAP showed significant viability reduction for C. albicans and S. aureus (1.385 and 0.831, respectively). The protocol was not cytotoxic to BEAS-2B. CAP can be a simple and effective method to delay multispecies biofilm formation inside the endotracheal prosthesis.

Cold Atmospheric Helium Plasma in the Post-COVID-19 Era: A Promising Tool for the Disinfection of Silicone Endotracheal Prostheses

Breast cancer is, by far, the most frequent cancer among women and many factors influence the physiological and pathological growth and development of the mammary gland.  There is developing evidence that the hormone ghrelin, known for the growth hormone releasing effect and food intake modulator, could also play a role in the pathogenesis of breast cancer and may represent a new diagnostic marker and a potential therapeutic target. We performed a PubMed Database search of relevant studies and ten papers were included in our systematic review. Ghrelin axis seems to be definitely involved in the pathogenesis of breast cancer, although a precise role has not been yet established. In order to verify the precise role of ghrelin axis in breast cancer further studies with larger populations are necessary that should include the analysis of metabolic, genetic and environmental factors which are expected to influence the results.

https://www.revmedchir.ro/index.php/revmedchir/article/download/424/378

Implications of ghrelin axis in breast cancer--review.

Aortic dissection (AD) presents a critical medical emergency characterized by a tear in the aortic wall, necessitating prompt recognition and management to mitigate catastrophic complications. Despite advancements in medical technology and therapeutic interventions, AD remains a formidable challenge, often resulting in severe morbidity and mortality. This narrative review provides a comprehensive overview of AD, encompassing its clinical presentation, diagnostic modalities

https://assets.cureus.com/uploads/review_article/pdf/242782/20240408-15426-rxgfek.pdf

Unraveling the Enigma of Aortic Dissection: From Genetics to Innovative Therapies

Background: Pathology of the aorta includes aortic aneurysms, coarctation, dissection, atherosclerotic disease, and aortitis. The only two evidence-based treatment options for abdominal aortic repair are endovascular and open surgery. The anesthetic approach and medications may impact the outcomes of the surgical repair of the abdominal aorta and its branches.

Aim: to evaluate the use of various analgesic regimens and local, regional, or general anesthesia in "optimising" surgical outcomes in patients undergoing surgical repair of the abdominal aorta and its branches.

Methods: In this review, English studies from common databases such as Pubmed/MEDLINE, Google Scholar, Web of Science, Scopus, and the Cochrane Library with the keywords "Abdominal aorta," "operations," "aortic branches," combined with keywords, involving " anesthesia were involved." The end date for this review was November 2022.

Scientific novelty: Recent scientific studies have focused on the use of advanced monitoring technologies such as cerebral oximetry and microdialysis to improve the safety and efficacy of anesthesia management in aortic surgery. These technologies provide more accurate and real-time information about cerebral perfusion and metabolism, allowing the anesthesiologist to identify and manage potential complications such as cerebral ischemia more effectively. Additionally, the use of pharmacological agents such as dexmedetomidine and remifentanil has been shown to reduce the risk of postoperative delirium and cognitive dysfunction, further improving patient outcomes.

Conclusion: Aortic surgery is a complex and high-risk procedure that requires careful management of anesthesia to ensure patient safety and optimal outcomes. With ongoing advances in anesthesia techniques and monitoring technologies, there is reason to be optimistic about the future of aortic surgery and the prospects for improved patient outcomes. The anesthesiologist plays a critical role in this process, working closely with the surgical team to provide safe and effective anesthesia throughout the procedure and ensuring that the patient receives appropriate pain management and other supportive care in the postoperative period

/pdf/optimising-anesthesia-support-during-operations-on-the-3apip927.pdf

Optimising anesthesia support during operations on the abdominal aorta and its branches

A remarkable increase in the number of patients presenting with tracheal complications after prolonged endotracheal intubation and mechanical ventilation for the management of the severe COVID-19-associated respiratory failure has been observed. In this study, we assessed the postoperative outcomes of tracheal resection in patients with COVID-19.We conducted a retrospective study in which all patients with a history of prolonged invasive mechanical ventilation due to COVID-19 infection, who were treated with tracheal resection and reconstruction, were included. The primary objective was in-hospital mortality and postoperative reintervention rate. The secondary objective was the time to tracheal restenosis.During the 16-month study period, 11 patients with COVID-19 with tracheal complications underwent tracheal resection with end-to-end anastomosis. Mean patient age was 51.5 ± 9 years, and the majority were male (9 patients). Eight patients were referred for management of postintubation tracheal stenosis, and 3 patients were referred for tracheoesophageal fistula. Eight patients had a history of tracheostomy during the COVID-19 infection hospitalization. There was 1 in-hospital death (9.1%) due to septicemia in the intensive care unit approximately 2 months after the operation. Postoperatively, 32 reinterventions were required for tracheal restenosis due to granulation tissue formation. The risk for reintervention was higher during the first 3 months after the index operation. Four patients developed tracheal restenosis (36.4%), and 2 of them required endotracheal stent placement during the follow-up period.Tracheal resection and reconstruction after COVID-19 infection are associated with a high reintervention rate postoperatively. Such patients require close follow-up in expert interventional pulmonology units, and physicians should be on high alert for the early diagnosis and optimal management of tracheal restenosis. 

https://doi.org/10.1016/j.xjtc.2023.01.006

Tracheal resection in patients post–COVID-19 is associated with high reintervention rate and early restenosis

The Role of Ghrelin Signals in Breast Cancer- A Systematic Review

Osteopathic manipulative treatment in cardiac surgery patients. A systematic review

Individual patient data meta-analysis of 10-year follow-up after endovascular and open repair for ruptured abdominal aortic aneurysms.

Echocardiographic changes in cardiac function after thoracic endovascular aortic repair: A systematic review and meta-analysis.

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