A Paradigm Shift of Airway Management: The Role of Video-Assisted Intubating Stylet Technique

Difficult or failed intubation is a major contributor to morbidity for patients and to liability for the provider. Research to improve understanding, prevention, and management of such complications remains an anesthetic priority, and a driving force behind continuous improvements in intubation techniques and intubation equipment. The purpose of this review article is to focus on the video-assisted intubating stylet technique (VS; also known as the Shikani optical stylet technique for intubation) and video-assisted optical stylet devices, both for routine use and alternative rescue application for tracheal intubation, and stress their advantages as compared to conventional direct laryngoscopy and videolaryngoscopy. The VS technique was introduced by Dr. Alan Shikani in 1996 and popularized with the advent of the Shikani optical stylet and subsequent similar stylets variations. We focus on the clinical details of the technique itself, and on the various advantages and troubleshooting under different clinical scenarios and practice settings. In our experience, video-assisted intubating stylet technique often constitutes the most appropriate approach both for daily routine and emergency airway management. Furthermore, we also emphasize the importance of video-assisted intubating stylets in enhancing the practitioner systems response when difficult or failed tracheal intubation is encountered

IL-33-mediated protection against experimental cerebral malaria is linked to induction of Type 2 innate lymphoid cells, M2 macrophages and regulatory T cells

Author Summary Cerebral malaria (CM) caused by the parasite Plasmodium sp . is a fatal disease, especially in children. Currently there is no effective treatment. We report here our investigation on the role of a recently discovered cytokine IL-33, in treating experimental cerebral malaria (ECM) in the susceptible C57BL/6 mice. IL-33 protects the mice against ECM. The protection is accompanied by a reduction of Th1 response and the enhancement of type 2 cytokine response. We also found that IL-33 mediates its protective effect by inducing a population of type 2 innate lymphoid cells (ILC2), which then polarize macrophages to alternatively-activated phenotypes (M2). M2 in turn expand regulatory T cells (Tregs) which suppress the deleterious Th1 response. Our report therefore reveals hitherto unrecognised mechanisms of the regulation of ECM and provide a novel function of IL-33

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS