Perioperative Hypothermia in Elderly Patients During Pelvic Floor Reconstruction Surgery: An Observational Study.

INTRODUCTION AND HYPOTHESIS: The potential predictors of pelvic floor reconstruction surgery hypothermia remain unclear. This prospective cohort study was aimed at identifying these predictors and evaluating the outcomes associated with perioperative hypothermia. METHODS: Elderly patients undergoing pelvic floor reconstruction surgery were consecutively enrolled from April 2023 to September 2023. Perioperative temperature was measured at preoperative (T1), every 15 min after the start of anesthesia (T2), and 15 min postoperative (T3) using a temperature probe. Perioperative hypothermia was defined as a core temperature below 36°C at any point during the procedure. Multivariate logistic regression analysis was conducted to determine factors associated with perioperative hypothermia. RESULTS: A total of 229 patients were included in the study, with 50.7% experiencing hypothermia. Multivariate analysis revealed that the surgical method involving pelvic floor combined with laparoscopy, preoperative temperature < 36.5°C, anesthesia duration ≥ 120 min, and the high levels of anxiety were significantly associated with perioperative hypothermia. The predictive value of the multivariate model was 0.767 (95% CI, 0.706 to 0.828). CONCLUSIONS: This observational prospective study identified several predictive factors for perioperative hypothermia in elderly patients during pelvic floor reconstruction surgery. Strategies aimed at preventing perioperative hypothermia should target these factors. Further studies are required to assess the effectiveness of these strategies, specifically in elderly patients undergoing pelvic floor reconstruction surgery.

Bougie approach improves first-attempt success rate compared to stylet approach in patients with difficult airway needing endotracheal intubation: a meta-analysis.

INTRODUCTION: Bougies and stylets are widely acknowledged as effective tools for managing endotracheal intubation, uncertainties persist regarding the comparative efficacy and safety of bougie versus stylet approaches in endotracheal intubation. EVIDENCE ACQUISITION: A comprehensive electronic search was conducted on the Cochrane Library, PubMed, and Embase databases from inception to December 9, 2023, using the keywords "endotracheal intubation," "bougie," and "stylet." This meta-analysis aims to evaluate and compare the performance of bougies and stylets in patients undergoing endotracheal intubation. EVIDENCE SYNTHESIS: A total of 12 articles, encompassing 2534 participants, were included in this meta-analysis. The bougie approach did not exhibit superiority in first-attempt success rate (83.6% vs. 81.7%; OR, 1.06, 95% CI, 0.49 to 2.29; P=0.89) and total intubation success rate (99.3% vs. 97.6%; OR, 2.32, 95% CI, 0.44 to 12.34; P=0.32, I2>50%, P<0.001). However, in patients with difficult airways, the bougie approach demonstrated a superior first-attempt success rate compared to the stylet approach (93.8% vs. 76.4%; OR, 5.25, 95% CI, 2.74 to 10.05; P<0.001). There was no significant difference in complications between the bougie and stylet approaches (P>0.05). CONCLUSIONS: For patients with difficult airway characteristics, our recommendation is to perform endotracheal intubation (ETI) using the bougie approach over the stylet approach, as it has been associated with a better first-attempt success rate. Notably, the advantages of using a bougie may be less pronounced for patients without signs of a difficult airway.

A Novel miRNA-hlo-miR-2-Serves as a Regulatory Factor That Controls Molting Events by Targeting CPR1 in Haemaphysalis longicornis Nymphs.

Successful completion of the molting process requires new epidermal growth and ecdysis of the old cuticle in Haemaphysalis longicornis (H. longicornis). MicroRNAs (miRNAs) participate in the development of organisms by inhibiting the expression of their target mRNAs. In this study, a novel tick-specific miRNA was identified and denoted hlo-miR-2 that serves as a novel regulator of molting events in H. longicornis nymphs by targeting a cuticular protein. The full length of this cuticular protein was first obtained and named it CPR1. A qRT-PCR analysis showed that hlo-miR-2 and CPR1 exhibit significant tissue and temporal specificity and that their transcription levels are negatively correlated during the molting process. CPR1, as a direct target of hlo-miR-2, was identified by a luciferase reporter assay in vitro. Agomir treatment indicated that the overexpression of hlo-miR-2 significantly reduced the protein expression level of CPR1, decreased the molting rate and delayed the molting time point in H. longicornis nymphs. RNA interference (RNAi) experiments demonstrated that CPR1 was significantly associated with the molting process in H. longicornis nymphs. Phenotypic rescue experiments convincingly showed that hlo-miR-2 participated in molting events by targeting CPR1 in H. longicornis nymphs. In summary, we present evidence demonstrating that miRNAs constitute a novel important regulator of molting events in addition to hormones. The described functional evidence implicating CPR1 in molting events contributes to an improved understanding of the distinct functions of the CPR family in ticks and will aid the development of a promising application of cuticular protein RNAi in tick control.