Anesthesiology
Audio Summaries

Phase 1 Study of Anito-cel, a d-Domain BCMA CAR T Cell for Refractory or Recurrent Myeloma

This phase 1 study investigates the safety and efficacy of anitocabtagene autoleucel (anito-cel), a BCMA-directed CAR T-cell therapy, in patients with relapsed or refractory multiple myeloma who have undergone multiple prior treatments. The results indicate a high response rate (100%) with a significant proportion achieving complete response (79%), while adverse events, particularly cytokine release syndrome and neurotoxicity, were mostly mild. The findings suggest that anito-cel may be a promising treatment option for this challenging patient population.

Effect of Screening with Multicancer Early-Detection Test on Late-Stage Cancer Diagnosis

The authors aimed to determine whether screening with a multicancer early-detection test, in addition to usual care, reduces the incidence of late-stage cancers (stage III or IV) compared to usual care alone. In a randomized controlled trial involving over 142,000 participants, they found no significant difference in the incidence rates of stage III or IV cancers between the two groups after three screening rounds. While there was a trend towards a lower incidence of stage IV cancers, the results were not conclusive, indicating the need for further follow-up.

Etuvetidigene Autotemcel for the Treatment of Wiskott-Aldrich Syndrome

This study investigates the efficacy and safety of etuvetidigene autotemcel (etu-cel), an autologous gene therapy, for treating Wiskott-Aldrich syndrome, a rare genetic disorder. The results indicate a high overall survival rate of 96% at both 1 and 5 years post-treatment, along with a significant reduction in severe infections and bleeding events after therapy. The findings suggest that etu-cel provides a sustained clinical benefit for patients with this condition.

Clinical Uses of Common Genetic Variants Associated with Common Diseases

The authors investigate why the integration of polygenic risk scores and genomic knowledge into clinical practice for common adult-onset diseases has been slow, despite advancements in genomics and the identification of numerous genetic variants associated with these conditions. They explore potential applications of these scores and pharmacogenomics in improving prevention and treatment strategies as genome sequencing becomes more accessible.

Current advancements in the care of peripheral arterial disease: modern approaches to medical, endovascular, and surgical treatment

The authors review current advancements in the management of peripheral arterial disease (PAD), particularly focusing on the effectiveness of medical therapy, supervised exercise, and the judicious use of revascularization procedures. They aim to address how to optimize treatment strategies to reduce cardiovascular risks, improve quality of life, and minimize limb loss in patients with varying severity of PAD. The paper highlights the complexities of PAD management due to its multifaceted nature and the potential overuse of invasive interventions.

Understanding peripheral arterial disease in the current era

The authors aim to address the underacknowledgment, underdiagnosis, and undertreatment of peripheral arterial disease (PAD) in the context of atherosclerotic cardiovascular disease, highlighting its increasing prevalence and significant mortality rates. They emphasize the need for improved recognition and interdisciplinary measures to enhance patient outcomes and advocate for better integration of preventive care and treatment strategies. This clinical series seeks to inform clinicians and policymakers about the global burden of PAD and effective approaches to manage it.

Peripheral arterial disease: adverse impacts, disparities in outcomes, and the path ahead

This paper aims to address the adverse impacts of peripheral arterial disease (PAD) and the disparities in outcomes among affected populations. The authors highlight the significant individual and societal burdens of PAD, particularly on underserved groups, and propose both short-term and long-term strategies to improve management and access to care, including enhanced awareness and multidisciplinary treatment approaches. The study emphasizes the need for targeted interventions to reduce the prevalence and consequences of PAD, especially in vulnerable communities.

Effects of lidocaine bolus and infusion on neuromonitoring by bispectral index (BIS®), electroencephalogram periodic and aperiodic activity, and Surgical Pleth Index® during propofol-remifentanil anaesthesia: a single-centre prospective observational study

The authors aimed to evaluate the dose-dependent effects of lidocaine on EEG spectral features and processed parameters like bispectral index (BIS) and spectral edge frequency (SEF) during propofol-remifentanil anesthesia. They found that lidocaine administration led to early changes in EEG activity, specifically an increase in delta-band and a decrease in beta-band activity, before any significant alterations in BIS, SEF, or Surgical Pleth Index (SPI) were observed. These findings suggest that lidocaine's antinociceptive effects may contribute to its anesthetic-sparing properties, although the interpretation of these EEG changes requires further investigation.

Effect of In-line Clinical Decision Support to Improve Accuracy of American Society of Anesthesiologists Physical Status Documentation: A Two Center Evaluation of a Quality Intervention

The authors aimed to evaluate the effectiveness of an in-line Clinical Decision Support (CDS) system in improving the accuracy of American Society of Anesthesiologists Physical Status (ASA PS) documentation, which is known for its inter-rater variability. Their study found that the implementation of the CDS significantly increased the proportion of patients classified as ASA PS 3 or greater at one academic medical center, while a control site showed only a minimal increase. This suggests that the CDS effectively enhances the accuracy of ASA PS assessments by addressing potential under-classification.

A Contemporary Survey of The Impact of Perioperative Catastrophes on Anesthesiologists

The authors aimed to reassess the impact of perioperative catastrophes on anesthesiologists, following a landmark survey in 2012, in light of evolving practices and increased attention to clinician well-being. Their findings reveal that a significant majority of anesthesiologists experience substantial emotional and physical distress after such events, with many reporting impaired clinical performance and a lack of adequate institutional support. The study highlights the ongoing need for improved peer support and recovery strategies to enhance clinician well-being and patient safety.