Perioperative Management in the Myasthenia Gravis Patient Exhibiting Postoperative Myasthenic Crisis: A Case Study

This case study examines the perioperative management of a 67-year-old male with myasthenia gravis (MG) who developed a postoperative myasthenic crisis following an emergent exploratory laparotomy that was converted to a Hartmann's procedure. The crisis was evidenced by respiratory failure, hypertension, and tachycardia. Despite appropriate reversal of neuromuscular blockade with sugammadex after rocuronium administration, the patient required intensive care unit admission and mechanical ventilation. This case highlights the limitations of standard rapid sequence induction dosing and reliance on twitch monitoring in patients with MG, as well as the contribution of additional exacerbating factors such as fluoroquinolone use (ciprofloxacin), surgical stress, and possible infection. A review of the literature suggests that neuromuscular blocker free total intravenous anesthesia (TIVA) using remifentanil may provide a safer anesthetic alternative in this population. Overall, this case highlights the importance of individualized anesthetic planning, careful medication selection, and heightened perioperative vigilance in patients with MG to reduce the risk of postoperative complications

Anesthetic Implications of Chronic Medical Marijuana Use in a Patient Undergoing Spinal Surgery: A Case Study

Chronic cannabis use is increasingly common among surgical patients and presents unique challenges for anesthesia providers. This case report describes a female patient with a history of daily medical marijuana use who underwent an L4-S1 posterior spinal fusion and L5-S1 transforaminal lumbar interbody fusion under total intravenous anesthesia. Despite high induction and maintenance doses of propofol and adjunctive agents, the patient exhibited increased anesthetic requirements, hemodynamic instability, and persistent sympathetic responses intraoperatively. Postoperatively, she reported severe pain despite receiving aggressive multimodal therapy and demonstrated markedly elevated opioid requirements over the first 48 hours. A review of current literature revealed consistent patterns of increased propofol needs, greater postoperative opioid consumption, and heightened nociception among cannabis users. This case highlights the importance of anticipating altered anesthetic responses and implementing individualized perioperative strategies to optimize safety and pain control in this expanding patient population

Epidural Versus General Anesthesia for Parturients With a Failed Spinal Undergoing Cesarean Section

Cesarean sections (C-section) are a common procedure performed to deliver babies. Globally, about 21% of all births are delivered by cesarean section, and in the United States, 32.2% of all live births are by C-section (WHO, 2021; Osterman et al., 2025). C-sections are most commonly performed under spinal anesthesia. However, there are times when spinal anesthetics are contraindicated or not effective. Therefore, general anesthesia is usually used as the anesthetic for the parturient. This report presents a case involving a patient who experienced a unilateral spinal which was recognized as a failed spinal and would not be effective as the primary anesthetic for the operation. The anesthesia team then decided to use an epidural for surgical anesthesia instead of converting to general anesthesia. It also reviews current literature regarding failed spinals and comparing the use of neuraxial versus general anesthesia for parturient patients receiving a cesarean section

Evaluation of Absolute Detection Limits for Dopamine and Serotonin in a Cyclic Voltammetry Experiment

This experiment investigated the electrochemical detection of dopamine and serotonin using cyclic voltammetry under acid buffer conditions. A phosphate buffer (H2PO4-/H3PO4) at pH 4.1 was used as the supporting electrolyte, and a three-electrode system consisting of an Ag/AgCl reference electrode, a platinum counter electrode, and a graphite working electrode was employed. The objective of this experiment was to simultaneously determine dopamine and serotonin in a mixture and to investigate the absolute detection limits that could be obtained by reducing the volume of the sample solution. Voltammograms showed distinct oxidation peaks for each compound, with dopamine appearing first and its intensity decreasing as serotonin increased confirming successful temporal separation and detection of both neurotransmitters. Ultimately experiments were able to be conducted in a 30 L sample at concentrations of 5 ppm, which corresponds to absolute detection limits of 150 ng or about 1 nmol

Neuroprotective Effects of Pogonomyrmex badius Venom on PTZ-Induced Seizure Activity in Camponotus floridanus

Epilepsy is a chronic disorder of the brain characterized by spontaneous recurrent seizure activity. Pentylenetetrazole (PTZ) is a widely used chemical convulsant that induces seizure-like behavior in various animal models used to study epileptic mechanisms. While there has been extensive research on vertebrate models, invertebrate models have been underexplored. However, invertebrate models are increasingly being explored due to their simplified and ethically accessible system. In addition to invertebrate models, invertebrates such as insects and spiders are progressively becoming the source for diverse bioactive compounds that modulate neurochemical pathways, suggesting potential neuroactive or anticonvulsant properties. This study aimed to explore possible neuroprotective effects of Pogonomyrmex badius venom on PTZ-induced seizure activity in Camponotus floridanus. Ants were exposed to differing treatments and then observed for seizure-like behavior. Dopamine expression was also assessed via neurochemical staining. PTZ exposure induced dose-dependent seizure-like activity across experimental groups, while control and venom only groups showed no seizure-like behaviors. However, when combined with PTZ, venom modulated seizure expression, with the most prominent effects occurring in late behavioral stages. Dopamine staining did not differ significantly across treatment groups. These findings suggest that P. badius venom acts as a modulator of PTZ-induced seizure expression. Additionally, seizure-like behavior in this model is stage-dependent, with distinct behavioral levels reflecting progressive neural disruption. Overall, C. floridanus represents a promising invertebrate model for studying seizure dynamics and venom-mediated modulation of neural excitability

Anesthetic Considerations and Approaches to Valvular Heart Surgery

Undergoing open heart surgery is a highly stressful procedure a patient can experience. Its difficulty lies not only in the surgical conditions, mechanical support, and complexity of the procedure, but also in the anesthetic management required to stabilize the patient. In addition, open-heart surgery often entails a prolonged recovery period. However, minimally invasive alternatives now exist. The rise of minimally invasive cardiac surgery has bypassed many of the challenges associated with traditional open-heart surgery and offers patients a significantly shorter recovery period. This case report describes a patient undergoing Transcatheter Aortic Valve Replacement (TAVR) and the aortic valve is accessed via the femoral artery. This minimally invasive approach eliminates the need for major open cardiac surgery and can quickly, relieve symptoms such as syncope, shortness of breath, and other sequelae of aortic valve disease. The purpose of the literature review is to examine and compare the safety and efficacy of general endotracheal anesthesia versus monitored anesthesia care (MAC) for TAVR procedures. This examination also aims to emphasize the importance of anesthetic choice and the associated clinical consequences

Contact Angle Goniometry Analysis of Gold-Silver Nanoshell Ink

Colloidal conductive inks are rapidly gaining interest in the printing of flexible electronics. Many inks have been tested in various printing styles, but they all have their downfalls, ranging from cost to conductivity. This research looks at gold-silver nanoshells (GS-NS) and their potential use as an optically and electrically active colloidal ink. GS-NS have the advantages of lower cost than gold nanoparticles, the biocidal properties of silver nanoparticles, and a tunable range of absorption wavelengths due to localized surface plasmon resonance (LSPR). With these advantages of GS-NS in mind, various ink formulations were developed in this study and the physical properties analyzed. The solvents studied were: water, ethanol, ethylene glycol, and glycerol. Among the five inks formulations studied, four included hydroxypropyl cellulose (HPC) functionalized GS-NS used for better stability in solvents. Pendant drop and contact angle of the inks were analyzed on three different substrates: photo paper, polyethylene terephthalate (PET), and Teflon (PTFE). Each substrate varied in polarity and porosity. Droplet radius, droplet height, and spreading were calculated, and trends were analyzed, while also adding discussions on the dried droplet statistics. Overall, our studies demonstrate a fine balance between effective wetting while limiting spreading, to generate the best adhesion and precision

Hot-hand Effect and Gambler's Fallacy in Equity Markets: Evidence from Short-selling Data

Using stock trade and short-selling data, we test two hypotheses proposed in Dorst (2026). First, investors' expectations about future returns are nonlinear in streak length. Specifically, as a streak lengthens, investors initially exhibit gambler's fallacy behavior, expecting the streak to end, but eventually shift toward hot-hand reasoning, increasingly expecting the streak to continue. Second, investors' expectations depend on the historical characteristics of the process. When past streaks tend to be short, investors are more likely to exhibit gambler's fallacy behavior; conversely, when streaks tend to be long, investors are more likely to follow hot-hand reasoning