Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Νευρικοί αποκλεισμοί για την αντιμετώπιση του πόνου των κακώσεων του θωρακικού τοιχώματος

Εισαγωγή: Οι κακώσεις του θώρακα είναι συχνές και ασθενείς που πάσχουν από θωρακικό τραύμα διατρέχουν υψηλό κίνδυνο ανάπτυξης σημαντικής νοσηρότητας και θνησιμότητας. Αυτό μπορεί να οφείλεται στον ίδιο τον τραυματισμό ή λόγω της ανάπτυξης δευτερογενών επιπλοκών, όπως αναπνευστική ανεπάρκεια και πνευμονία. Η σωστή αντιμετώπιση του συνοδού οξέος πόνου είναι ζωτικής σημασίας. Σκοπός: Η συλλογή και ανάλυση των αναγκαίων πληροφοριών σχετικά με τους νευρικούς αποκλεισμούς που εφαρμόζονται για την αντιμετώπιση του πόνου στις κακώσεις θωρακικού τοιχώματος. Υλικό και μέθοδος: Πραγματοποιήθηκε βιβλιογραφική ανασκόπηση στις επιστημονικές βάσεις δεδομένων, όπου με βάση συγκεκριμένες λέξεις-κλειδιά, συλλέχθηκαν οι απαιτούμενες πληροφορίες για τους νευρικούς αποκλεισμούς στις κακώσεις του θώρακα. Αποτελέσματα/Συμπεράσματα: Οι τεχνικές που αφορούν τον αποκλεισμό στο επίπεδο του πρόσθιου οδοντωτού μυός και το επίπεδο του ανελκτήρα μυός της ράχης θεωρούνται λιγότερο επεμβατικές, έχουν ελάχιστες επιπλοκές, ενώ αποτελούν τεχνικές με εύκολη εκμάθηση που αποτελούν εναλλακτικές επιλογές της θωρακικής επισκληριδίου αναλγησίας και του παρασπονδυλικού θωρακικού αποκλεισμού. Για την εφαρμογή αυτών των νευρικών αποκλεισμών για την αντιμετώπιση του θωρακικού τραύματος απαιτείται λεπτομερής γνώση της ανατομίας των μυών, των περιτονιών και των νεύρων του θωρακικού τοιχώματος.Introduction: Chest injuries are common and patients with chest trauma are at high risk of developing significant morbidity and mortality. This may be due to the injury itself or to the development of secondary complications, such as respiratory failure and pneumonia. Appropriate management of the accompanying acute pain is vital. Purpose: The review and analysis of the necessary information on nerve blocks suitable for pain management in chest trauma injuries. Material and method: A literature review was performed in the scientific databases, where based on specific keywords, the required information for the nerve blockages in the chest injuries was collected. Results/Conclusions: Techniques involving exclusion at the level of the anterior dentate gyrus and the level of the lumbar spine muscle are considered less invasive, have minimal complications, and are easy-to-learn techniques that are alternatives to thoracic epidural analgesia and thoracic paravertebral block. Applying these nerve blocks to treat a chest injury requires detailed knowledge of the anatomy of the muscles, fascia, and nerves of the chest wall

Biomolecule and Bioentity Interaction Databases in Systems Biology: A Comprehensive Review.

Technological advances in high-throughput techniques have resulted in tremendous growth of complex biological datasets providing evidence regarding various biomolecular interactions. To cope with this data flood, computational approaches, web services, and databases have been implemented to deal with issues such as data integration, visualization, exploration, organization, scalability, and complexity. Nevertheless, as the number of such sets increases, it is becoming more and more difficult for an end user to know what the scope and focus of each repository is and how redundant the information between them is. Several repositories have a more general scope, while others focus on specialized aspects, such as specific organisms or biological systems. Unfortunately, many of these databases are self-contained or poorly documented and maintained. For a clearer view, in this article we provide a comprehensive categorization, comparison and evaluation of such repositories for different bioentity interaction types. We discuss most of the publicly available services based on their content, sources of information, data representation methods, user-friendliness, scope and interconnectivity, and we comment on their strengths and weaknesses. We aim for this review to reach a broad readership varying from biomedical beginners to experts and serve as a reference article in the field of Network Biology

OnTheFly2.0: a text-mining web application for automated biomedical entity recognition, document annotation, network and functional enrichment analysis.

Extracting and processing information from documents is of great importance as lots of experimental results and findings are stored in local files. Therefore, extracting and analyzing biomedical terms from such files in an automated way is absolutely necessary. In this article, we present OnTheFly2.0, a web application for extracting biomedical entities from individual files such as plain texts, office documents, PDF files or images. OnTheFly2.0 can generate informative summaries in popup windows containing knowledge related to the identified terms along with links to various databases. It uses the EXTRACT tagging service to perform named entity recognition (NER) for genes/proteins, chemical compounds, organisms, tissues, environments, diseases, phenotypes and gene ontology terms. Multiple files can be analyzed, whereas identified terms such as proteins or genes can be explored through functional enrichment analysis or be associated with diseases and PubMed entries. Finally, protein-protein and protein-chemical networks can be generated with the use of STRING and STITCH services. To demonstrate its capacity for knowledge discovery, we interrogated published meta-analyses of clinical biomarkers of severe COVID-19 and uncovered inflammatory and senescence pathways that impact disease pathogenesis. OnTheFly2.0 currently supports 197 species and is available at http://bib.fleming.gr:3838/OnTheFly/ and http://onthefly.pavlopouloslab.info

Biomolecule and Bioentity Interaction Databases in Systems Biology:A Comprehensive Review

Technological advances in high-throughput techniques have resulted in tremendous growth of complex biological datasets providing evidence regarding various biomolecular interactions. To cope with this data flood, computational approaches, web services, and databases have been implemented to deal with issues such as data integration, visualization, exploration, organization, scalability, and complexity. Nevertheless, as the number of such sets increases, it is becoming more and more difficult for an end user to know what the scope and focus of each repository is and how redundant the information between them is. Several repositories have a more general scope, while others focus on specialized aspects, such as specific organisms or biological systems. Unfortunately, many of these databases are self-contained or poorly documented and maintained. For a clearer view, in this article we provide a comprehensive categorization, comparison and evaluation of such repositories for different bioentity interaction types. We discuss most of the publicly available services based on their content, sources of information, data representation methods, user-friendliness, scope and interconnectivity, and we comment on their strengths and weaknesses. We aim for this review to reach a broad readership varying from biomedical beginners to experts and serve as a reference article in the field of Network Biology

OnTheFly2.0:a text-mining web application for automated biomedical entity recognition, document annotation, network and functional enrichment analysis

Extracting and processing information from documents is of great importance as lots of experimental results and findings are stored in local files. Therefore, extracting and analyzing biomedical terms from such files in an automated way is absolutely necessary. In this article, we present OnTheFly2.0, a web application for extracting biomedical entities from individual files such as plain texts, office documents, PDF files or images. OnTheFly2.0 can generate informative summaries in popup windows containing knowledge related to the identified terms along with links to various databases. It uses the EXTRACT tagging service to perform named entity recognition (NER) for genes/proteins, chemical compounds, organisms, tissues, environments, diseases, phenotypes and gene ontology terms. Multiple files can be analyzed, whereas identified terms such as proteins or genes can be explored through functional enrichment analysis or be associated with diseases and PubMed entries. Finally, protein-protein and protein-chemical networks can be generated with the use of STRING and STITCH services. To demonstrate its capacity for knowledge discovery, we interrogated published meta-analyses of clinical biomarkers of severe COVID-19 and uncovered inflammatory and senescence pathways that impact disease pathogenesis. OnTheFly2.0 currently supports 197 species and is available at http://bib.fleming.gr:3838/OnTheFly/ and http://onthefly.pavlopouloslab.info