A 10-year-old male Shar-Pei was referred for lethargy and proprioceptive deficits of the left thoracic limb. An magnetic resonance imaging (MRI) examination of the cervical spinal column and the brain was performed. The MRI examination of the brain was normal. A left-sided C3-C4 intervertebral disc extrusion with spinal cord compression was diagnosed. Medical treatment was elected. Within a week after the MRI examination, the dog presented with deep partial-thickness skin burn wounds in both axillae. Since the specific absorption rate had not exceeded the safety limits during any of the scans and no other procedures or circumstances were identified that could possibly have resulted in burn injuries, the thermal burn injuries were diagnosed as radiofrequency (RF) burns. The wounds healed by secondary intent over the next month. RF burns are the most reported complication in humans undergoing MRI but have not been reported in veterinary patients. Clinicians and technicians should consider the potential risk for RF burns in veterinary patients and take precautions regarding positioning of the patient and take notice of any signs of burn injury when performing follow-up examinations.

OBJECTIVE: To comprehensively analyze reported cases of nasolacrimal squamous cell carcinoma (NLSCC), focusing on risk factors, treatment modalities, and outcomes. Additionally, investigate the impact of human Papillomavirus (HPV) status and histopathological subtypes\' impact on prognosis.
METHODS: Pubmed, Embase.
METHODS: We conducted a systematic literature review to identify relevant studies reporting cases of NLSCC. The review methods adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The final update was performed on May 31, 2023.
RESULTS: The 72 studies included a total of 313 participants (mean age: 55; 60% male). Longer symptom duration (44.1 ± 59.2 months) correlated with recurrence (p = 0.004), and males exhibited higher mortality rates (19.6% vs. 2.4% in females, p = 0.01). The overall survival (OS) rate among all patients was 87.1%. Basaloid NLSCC had a worse death outcome (p ≤ 0.001). HPV-positive cases showed comparable OS, recurrence, and metastasis rates to the general population (p = 0.917, 0.851, 0.07, respectively). Comparing treatment approaches (surgery, surgery with adjuvant radiation, chemoradiotherapy [CRT] followed by surgery), no significant differences in 5 and 10-year OS rates or recurrence were observed (p = 0.4, 0.24, respectively), but 5-year metastasis events were significant (p = 0.024). Eye exenteration rates were 31.1%, 20%, and 0% for the respective treatments (p = 0.089). Induction chemotherapy saved four cases from potential exenteration with favorable prognosis.
CONCLUSIONS: Early detection and diagnosis are of utmost importance in the management of NLSCC. Regardless of the treatment approach, HPV-related NLSCC demonstrated similar outcomes to the general population. Basaloid histology represents the worst subtype in terms of prognosis. Limited adjuvant CRT cases showed improved outcomes and induction chemotherapy\'s importance was emphasized in recent literature and our shared experience. Laryngoscope, 134:3892-3902, 2024.

Benzylisoquinolinium neuromuscular blocking agents can precipitate bronchospasm either through allergy/anaphylaxis or isolated stimulation of mast cell histamine release. This report presents a 75-year-old female who attended the day surgery unit for a rigid cystoscopy under general anaesthesia. She had a hyper-reactive airway history of mild historic asthma and sensitivity to aerosols. After administration of atracurium at induction of anaesthesia, ventilation became challenging with no chest rise and a flat CO2 trace. Repeat video laryngoscopy confirmed correct endotracheal tube position. The patient remained cardiovascularly stable with no mucocutaneous signs of anaphylaxis. Administration of high flow oxygen, sevoflurane, salbutamol and magnesium sulfate led to gradual improvement and normalisation of respiratory parameters. Surgery was postponed. This report highlights atracurium as an important trigger of bronchospasm at induction of anaesthesia, and illustrates that in rare cases a flat capnograph does not always indicate a mispositioned airway device. Several aspects of the anaesthetic plan for this patient were suboptimal given her respiratory history, namely, the choice of mode of anaesthesia and choice of neuromuscular blocking agent. These factors are discussed in the context of anaesthetic planning for patients presenting with features suggesting high bronchospastic risk.

A combination of azacitidine and venetoclax (AZA-VEN) has been approved for the treatment of adult treatment-naïve acute myeloid leukemia (AML) patients, ineligible for intensive chemotherapy. The protocol may also constitute an alternative for the treatment of patients with mixed phenotype acute leukemia (MPAL), for which no established treatment guidelines exist. It may be anticipated, that alike in AML or chronic lymphocytic leukemia, the treatment of MPAL may be complicated by the tumor lysis syndrome (TLS). No case of TLS in MPAL after VEN has been however reported so far. Here, we present a case of a patient with MPAL, who received AZA-VEN. The patient had a substantial bulk of disease with generalized lymphadenopathy and increased white blood cell count. Despite preventive measures, the patient developed the clinical TLS, which was successfully treated. Based on the current case and other published cases, the incidence of TLS after AZA-VEN was established at 17%.

To identify the ideal gestational age at delivery for preterm premature rupture of membranes and modalities of birth.
To identify studies, research was conducted using Pub-Med, Embase and Cochrane databases.
Prolonged latency duration after pPROM does not worsen neonatal prognosis (NP3). Therefore, it is recommended not to deliver before 34 weeks of gestation for patient with uncomplicated preterm rupture of membranes (pPROM) (Grade C). After 34 weeks of gestation, expectant management for pPROM is not associated with neonatal sepsis (NP1) but is associated to intra-uterine infection (NP2). Early delivery is associated with higher risk of respiratory distress syndrome (NP2), higher risk of cesarean section (NP2) and longer duration of NICU hospitalization (NP2). Before 37 weeks of gestation, expectant management is recommended for uncomplicated pPROM (Grade A), even if vaginal group B streptococcus is positive, as long as antibiotics are used at the time of membranes rupture (Professional consensus). Elective cesarean section is reserved for usual obstetrical indications. Oxytocin and prostaglandins are reasonable options for inducing labor (Professional consensus). Data are too scarce to establish recommendation regarding intra-cervical balloons in case of pPROM (Professional consensus).
Expectant management is recommended for uncomplicated pPROM before 37 weeks of gestation.

UNASSIGNED: Sublingual buprenorphine is indicated for opioid dependence. It comes in 2 formulations: a mono buprenorphine product (BUP) and a combination product containing naloxone (BUP-NAL), which functions as an abuse deterrent. Sublingual naloxone does not reach clinically significant levels except in cases of hepatic impairment, where its metabolism can be impaired. Substantial naloxone accumulation could block the therapeutic effects of buprenorphine. The risk of hepatic impairment is elevated in the opioid dependence population, and our case highlights the need for careful evaluation of hepatic function and consideration of BUP.
UNASSIGNED: We report a patient with end-stage liver disease who began BUP-NAL induction with modest improvement on treatment day 1 followed by sustained withdrawal after receiving an observed dose on day 2. He returned to the clinic 2 days after his second successive day of BUP-NAL, vomiting and complaining of persistent withdrawal. To avoid potential accumulation of naloxone, the patient was eventually switched to and stabilized on BUP with good response.
UNASSIGNED: The clinical course this patient experienced during induction makes a case that naloxone can accumulate and interfere with the effectiveness of buprenorphine in the presence of liver dysfunction. Our case highlights the need for consideration of BUP in circumstances where patient safety and effective treatment outweigh the risks of prescribing a product with abuse deterrent properties.

Ameloblastic fibrodentinoma is a benign odontogenic tumor belonging to the category of \"odontogenic epithelium with odontogenic ectomesenchyme\" along with recognition of induction in the form of dentin in atypical or dysplastic forms. The biological behaviour of ameloblastic fibrodentinoma is not very different from ameloblastic fibroma; hence, it is treated similarly by conservative procedures. It is important to understand the histopathogenesis of these rare tumors. Though rare, they are an independent entity awaiting recognition. Here, we report a case of amelobalstic fibrodentinoma in a 14-year-old female patient.

BACKGROUND: Dormancy in higher plants is an adaptive response enabling plant survival during the harshest seasons and has been more explored in woody species than in herbaceous species. Nevertheless, winter and summer shoot meristem dormancy are adaptive strategies that could play a major role in enhancing seasonal stress tolerance and resilience of widespread herbaceous plant communities.
METHODS: This review outlines the symmetrical aspects of winter and summer dormancy in order to better understand plant adaptation to severe stress, and highlight research priorities in a changing climate. Seasonal dormancy is a good model to explore the growth-stress survival trade-off and unravel the relationships between growth potential and stress hardiness. Although photoperiod and temperature are known to play a crucial, though reversed, role in the induction and release of both types of dormancy, the thresholds and combined effects of these environmental factors remain to be identified. The biochemical compounds involved in induction or release in winter dormancy (abscisic acid, ethylene, sugars, cytokinins and gibberellins) could be a priority research focus for summer dormancy. To address these research priorities, herbaceous species, being more tractable than woody species, are excellent model plants for which both summer and winter dormancy have been clearly identified.
CONCLUSIONS: Summer and winter dormancy, although responding to inverse conditions, share many characteristics. This analogous nature can facilitate research as well as lead to insight into plant adaptations to extreme conditions and the evolution of phenological patterns of species and communities under climate change. The development of phenotypes showing reduced winter and/or enhanced summer dormancy may be expected and could improve adaptation to less predictable environmental stresses correlated with future climates. To this end, it is suggested to explore the inter- and intraspecific genotypic variability of dormancy and its plasticity according to environmental conditions to contribute to predicting and mitigating global warming.

Laryngeal cysts are largely asymptomatic and typically described in the context of incidental discovery on routine laryngoscopy. These cysts, in adults are even rarer and can have catastrophic consequences in an anaesthetized patient if airway management is inappropriate. We describe a case of difficult endotracheal intubation and the treatment of an adult patient with an asymptomatic, giant vallecular cyst that was discovered during rapid-sequence induction of general anesthesia in urgent surgery. In conclusion, vallecular cysts can cause extreme problems in securing the airway. It is important to avoid complications associated with repeated attempts at intubation, airway loss, or cyst rupture causing difficulty visualizing vocal cords and aspiration. The use of King Vision® videolaryngoscope is a good alternative in these cases. Close attention to logistics and the immediate availability of an otolaryngologist is vital.

On time start of the first case of the day is an important operating room (OR) efficiency metric, in which delays can have effects throughout the day. Although previous studies have identified various causes of first case start delays, none have attempted to evaluate the effect anesthesia staffing ratios have on first case start times. We performed a single-center retrospective analysis at an academic teaching hospital. Data was collected and analyzed over a period of 4 years and on more than 8,700 cases. We examined whether staffing ratios of attending only (solo staffing ratio), attending working with 1 resident/certified registered nurse anesthetist (CRNA) (1 to 1), or attending covering 2 residents/CRNAs (1 to 2) had a significant effect on first patient in room time (FPIR) and first case on time start (FCOTS). In addition, we examined whether staffing ratios had an effect on start times in various surgical subspecialties. We performed a univariate logistic regression analysis to determine if age, anesthesia base units, American Society of Anesthesiologists Physical Status (ASA PS) classification score, and staffing ratio was associated with FPIR and FCOTS being on time. Then, we performed a multivariate logistic regression analysis to determine if staffing ratio was associated with these outcomes, utilizing age, anesthesia base units, and ASA PS class as covariates. A decreased odds for FPIR being on time were seen in general and orthopedic surgeries when staffed 1 to 1, and cardiac surgery when staffed 1 to 2, when compared to solo staffing. FCOTS showed statistically significant differences when looking at all services with solo staffing having the highest odds for FCOTS being on time. This effect was seen also when analyzing only oncologic and orthopedic surgeries. Hospitals should consider using different staffing ratios in different surgical specialties to minimize delays and maximize OR efficiency.