Jornal de Anestesiologia e Pesquisa da Dor

Systemic Sclerosis (SSc) is a complex autoimmune disease characterized by fibrosis of the skin and internal organs, vascular abnormalities, and dysregulation of the immune system. The etiology and pathogenesis of SSc involve intricate interactions between genetic predisposition and environmental factors. Recent studies have highlighted the potential involvement of Interferon Regulatory Factor 8 (IRF8) polymorphisms in the development and pathogenesis of SSc. IRF8 is a critical transcription factor involved in the regulation of immune responses, including the differentiation and function of dendritic cells and macrophages. This review aims to unravel the role of IRF8 polymorphisms in SSc susceptibility, clinical manifestations, disease progression, and treatment response. Understanding the genetic variations in IRF8 and their impact on immune dysregulation in SSc may provide valuable insights into disease mechanisms and facilitate the development of targeted therapies.

Procedural sedation in older patients presents unique challenges due to age-related changes in physiology and increased susceptibility to adverse events. Remimazolam, a novel ultra-short-acting benzodiazepine, has emerged as a promising agent for procedural sedation in this population. This article provides a systematic review and meta-analysis of existing literature to evaluate the efficacy and safety of remimazolam in older patients undergoing procedural sedation. Additionally, Trial Sequential Analysis (TSA) is employed to determine the robustness of current evidence and ascertain if further research is warranted.

Ischemic stroke is a leading cause of mortality and long-term disability worldwide. Despite significant advancements in stroke management, effective therapeutic strategies remain limited. Emerging evidence suggests that the PERK (protein kinase RNA-like endoplasmic reticulum kinase) signaling pathway plays a pivotal role in the pathophysiology of ischemic stroke. This article explores the molecular mechanisms underlying PERK activation during ischemic insult and discusses the therapeutic potential of targeting this pathway in stroke management.

 Extra-Corporeal Membrane Oxygenation (ECMO) has emerged as a vital therapeutic option for pregnant women facing severe respiratory or cardiac compromise. However, its application in pregnancy presents unique challenges and considerations due to the physiological changes occurring during gestation. This article comprehensively explores the use of ECMO in pregnancy, discussing indications, contraindications, complications, ethical considerations and clinical management strategies. By elucidating the current evidence and guidelines, this article aims to provide healthcare professionals with a deeper understanding of ECMO utilization in pregnant patients, thereby optimizing maternal and fetal outcomes.