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• Stable Gastric Pentadecapeptide BPC 157 May Recover Brain–Gut Axis and Gut–Brain Axis Function
  Predrag Sikiric, Slaven Gojkovic, Ivan Krezic, Ivan Maria Smoday, Luka Kalogjera, Helena Zizek, Katarina Oroz, Hrvoje Vranes, Vlasta Vukovic, May Labidi, Sanja Strbe, Lidija Baketic Oreskovic, Marko Sever, Marijan Tepes, Mario Knezevic, Ivan Barisic, Vlad
  Pharmaceuticals.2023; 16(5): 676.     CrossRef
• The anti-nociceptive effect of BPC-157 on the incisional pain model in rats
  Young-Hoon Jung, Haekyu Kim, Hyaejin Kim, Eunsoo Kim, Jiseok Baik, Hyunjong Kang
  Journal of Dental Anesthesia and Pain Medicine.2022; 22(2): 97.     CrossRef
• Stable Gastric Pentadecapeptide BPC 157 as Useful Cytoprotective Peptide Therapy in the Heart Disturbances, Myocardial Infarction, Heart Failure, Pulmonary Hypertension, Arrhythmias, and Thrombosis Presentation
  Predrag Sikiric, Mario Udovicic, Ivan Barisic, Diana Balenovic, Gordana Zivanovic Posilovic, Dean Strinic, Sandra Uzun, Suncana Sikiric, Ivan Krezic, Helena Zizek, Haidi Yago, Slaven Gojkovic, Ivan Maria Smoday, Luka Kalogjera, Hrvoje Vranes, Marija Sola,
  Biomedicines.2022; 10(11): 2696.     CrossRef
• Stable Gastric Pentadecapeptide BPC 157 and Striated, Smooth, and Heart Muscle
  Mario Staresinic, Mladen Japjec, Hrvoje Vranes, Andreja Prtoric, Helena Zizek, Ivan Krezic, Slaven Gojkovic, Ivan Maria Smoday, Katarina Oroz, Eva Staresinic, Vilim Dretar, Haidi Yago, Marija Milavic, Suncana Sikiric, Eva Lovric, Lovorka Batelja Vuletic,
  Biomedicines.2022; 10(12): 3221.     CrossRef

Tracheostomy is increasingly performed in children for upper airway anomalies. Here, an 18-month-old child (height 84.1 cm, weight 12.5 kg) presented to the emergency department with dyspnea, stridor, and chest retraction. However, exploration of the airways using a bronchoscope failed due to subglottic stenosis. Therefore, a surgical tracheostomy was successfully performed with manual mask ventilation. However, pneumomediastinum was found in the postoperative chest radiograph. Although an oxygen saturation of 99% was initially maintained, oxygen saturation levels dropped, due to sudden dyspnea, after 3 hours. A chest radiograph taken at this time revealed a left tension pneumothorax and small right pneumothorax. Despite a needle thoracostomy, the pneumothorax was aggravated, and cardiac arrest occurred. Cardiopulmonary-cerebral resuscitation was performed, but the patient was declared dead 30 minutes later. This study highlights the fatal complications that can occur in children during tracheostomy. Therefore, close monitoring, immediate suspicion, recognition, and aggressive management may avoid fatal outcomes.

In this case report, we describe the use of ultrasound in the administration regional anesthesia for a super-super obese patient. A 23-year-old female patient (height 167.2 cm, weight 191.5 kg, body mass index 68.6 kg/m²) was admitted to the hospital for surgical repair of an anterior talofibular ligament rupture. We used ultrasound to help facilitate the administration of regional anesthesia. In the sagittal view of the lumbar spine, (with the patient in a sitting position) we were able to identify the border between the sacrum and the lumbar vertebral; in the transverse view, we were able to identify the transverse process, posterior dura, vertebral body, and the distance from the skin to the posterior dura. After skin marking, regional anesthesia was successfully performed. Based on this case study, we suggest that ultrasound can be very useful in regional anesthesia for severely obese patients.

Citations

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• Anaesthetic implications in a case of super obesity with multiple comorbidities: A conundrum of challenges
  Sathya Narayanan K, Ilango Ganesan, Gowtham Rajan, Nithya Dhanabal, Teresa Mary, Rajalakshmy Aarthy
  Indian Journal of Clinical Anaesthesia.2023; 10(1): 106.     CrossRef

Knotting of a pulmonary artery catheter (PAC) is a rare, but well-known complication of pulmonary artery (PA) catheterization. We report a case of a double-knotted PAC with a large loop in a patient with hepatocellular carcinoma (HCC) undergoing liver transplantation, which has been rarely reported in the literature. A PAC was advanced under pressure wave form guidance. PAC insertion was repeatedly attempted and the PAC was inserted 80 cm deep even though PAC should be normally inserted 45 to 55 cm deep. However, since no wave change was observed, we began deflating and pulling the balloon. At the 30-cm mark, the PAC could no longer be pulled. Fluoroscopy confirmed knotting of the PAC after surgery (The loop-formed PAC was shown in right internal jugular vein); thus, it was removed. For safe PA catheterization, deep insertion or repeated attempts should be avoided when the catheter cannot be easily inserted into the pulmonary artery. If possible, the insertion of PACs can be performed more safely by monitoring the movement of the catheter under fluoroscopy or transesophageal echocardiography.

An incidentaloma is a tumor found incidentally without clinical symptoms or suspicion; the lesion may be adrenal, pituitary, or thyroidal. We report the case of an asymptomatic individual with preoperatively undiagnosed pheochromocytoma (size: 4.86 cm) that was revealed using elective nonadrenal surgical procedures. The patient demonstrated peri- and post-operative hypertensive crisis and tachycardia. Three days after the dramatic onset of symptoms, the patient expired due to pulmonary edema, multiple organ failure, and terminal sepsis, despite administration of extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation. A left medial kidney mass obtained at autopsy confirmed pheochromocytoma.