PAS-403 / Pascal Biosci, University of Washington - LARVOL DELTA

ST403. Airway Management in Complex Neuroanesthesia Scenarios - Decoding the Decision Making Process (1 PS, 1 CME) (ASA 2025) - "They will gain knowledge of various airway devices and understand the appropriate use of each, ultimately leading to improved patient outcomes. SessionLearningObjective1: Interpret the data on preoperative airway evaluation in a neurosurgical patient with a challenging airway such as traumatic brain/spine injury and acromegaly.SessionLearningObjective2: Formulate a plan of airway management in a desaturating patient undergoing awake craniotomy with the head fixed in pins or a stereotaxic frame.SessionLearningObjective3: Construct a plan to manage a patient coming back to the operating room with an expanding neck hematoma after a carotid endarterectomy."

Acromegaly • Anesthesia • Cardiovascular • Endocrine Disorders • Obesity

Increase of macrolide resistance among Streptococcus pyogenes pharyngitis driven by a mef(A)-msr(D)/emm2-ST55 lineage in Portugal (2014-2019). (PubMed, Antimicrob Agents Chemother) - "Overall, 84 (4%), 77 (4%), and 52 (3%) isolates were resistant to erythromycin, clindamycin, and tetracycline, respectively...Other minor resistant lineages carried mostly erm(B) in a diversity of mobile genetic elements, including emm75-ST150, emm9-ST75, emm11-ST403, emm12-ST36, emm76-ST50, and emm77-ST399 [erm(T)]. Tetracycline resistance was associated with the genes tet(M) and tet(O), in most cases co-located in the same genetic elements as the erm genes. This study reveals clonal changes among macrolide-resistant GAS driving fluctuations in macrolide resistance and associated phenotypes."

Journal • Infectious Disease

Genomic variability of lipooligosaccharide biosynthesis locus and sequence type among Campylobacter jejuni isolated from patients with Guillain-Barré syndrome. (PubMed, Microbiol Spectr) - "Sequence types ST-43 and ST-2042 and clonal complexes ST-403 cc and ST-21 cc were overrepresented in GBS compared to enteritis-associated strains...In addition, the results of this study will facilitate future comparisons by identifying genomic differences in lipooligosaccharide biosynthesis and sequence types between C. jejuni strains linked to GBS. This will enhance our understanding of the genomic variation of the LOS region and their role in GBS development."

Journal • Gastrointestinal Disorder • Immunology • Infectious Disease

Genomic characterization of group A Streptococcus of different emm-type in Tianjin City from 2011 to 2024 (PubMed, Zhonghua Yu Fang Yi Xue Za Zhi) - "In this study, the GAS strains were dominated by emm1 (50.0%) and emm12 (40.4%), and the MLST phenotypes were categorized into six types: ST36 (40.4%), ST1274 (26.1%), ST28 (23.8%), ST921 (4.7%), ST46 (2.3%), and ST403 (2.3%). The results of drug sensitivity showed that the GAS strains isolated in Tianjin City from 2011 to 2024 were sensitive to penicillin, cefazolin, chloramphenicol, vancomycin, and levofloxacin, while the resistance rates to erythromycin, azithromycin, clarithromycin, and clindamycin ranged from 88.5% to 100.0%, and there was a certain degree of consistency between the resistance phenotypes and the detected resistance genes. Overall, the main emm types and evolutionary features of GAS in Tianjin City from 2011 to 2024 were consistent with the dominant types in China, and the carrying rate of virulence genes and drug resistance genes differed significantly among different emm-type strains, and there were continuous evolution and variation in the..."

Journal

Antimicrobial Resistance and Genomic Insights into Enterococcus faecalis Isolates from Broilers and Their Handlers in Punjab, India. (PubMed, Foodborne Pathog Dis) - "High resistance was observed for erythromycin (96.11%), tetracycline (78.64%), ciprofloxacin (76.69%), streptomycin (76.69%), and linezolid (65.04%), with 83.49% of isolates exhibiting multidrug resistance (MDR). Vancomycin resistance genes (vanC1-34.95% and vanC2/C3-9.70%) were also detected...Sequence typing identified was ST-1866, ST-7317, and ST-403, with ST-7317 common between broiler droppings and handler swab isolates, indicating potential transmission. While these findings highlight poultry environments as reservoirs for MDR E. faecalis, the directionality of transmission (zoonotic vs. reverse zoonotic) remains unclear. This underscores the need for expanded surveillance and molecular studies to better understand transmission dynamics and mitigate risks to farm workers and public health."

Journal

ST403. Geriatric Anesthesia: Beyond Brain Health and Frailty (ASA 2024) - "Learning Objective 2 Learn perioperative pain and fluid management strategies, as well as utilization of cardiovascular risk factors in geriatric population. Learning Objective 3 Understand the age-related changes in gut microbiota and their relevance on perioperative outcomes"

Anesthesia • Cardiovascular • Geriatric Disorders • Pain

ST403. Pathways to Leadership: Perspectives from Under-Represented Minority Leaders (ASA 2023) - "Relevance: Inspire aspiring leaders from URM backgrounds to attain leadership positions, increase visibility of strong URM leaders to be role models for the next generation of URM leaders. Post session learning: Increase understanding of career development strategies, recognize potential challenges to attaining leadership role as an URM and how to overcome them, potential pipeline to recognized URM leaders for further mentorship"

ST403. When Your PACU Turns Into an ICU (ASA 2022) - "Identify and treat causes of delayed emergence allowing for timely extubation and neurologic assessment. Explain judicious postoperative pain control while preventing hypercapnic respiratory failure in the PACU."

Anesthesia • Cardiovascular • Obstructive Sleep Apnea • Pain • Respiratory Diseases • Sleep Disorder

ST403. The Snap on Meds: Recent Insights Into New and Old Perioperative Medications (ASA 2021) - "Identify the mechanism of action of sugammadex and compounds it binds to, not only non-depolarizing muscle relaxants. Describe the benefits and disadvantages of incorporating ketamine into your perioperative regimen. Differentiate cannabis myths from facts."

Allergy • Anesthesia • Cardiovascular • Immunology

Deciphering mobile genetic elements disseminating macrolide resistance in Streptococcus pyogenes over a 21 year period in Barcelona, Spain. (PubMed, J Antimicrob Chemother) - "We detected several different MGEs harbouring erm(B) or erm(TR). This is the first known description of Tn6263 in GAS and three MGEs [IMESp316HUB, ICESp3729HUB and ICESp1070HUB] associated with MR. Periods of high MR rates in our area were mainly associated with the expansion of certain predominant lineages, while in low MR periods different sporadic and low prevalence lineages were more frequent."

Journal

Viability and stress state of bacteria associated with primary production or zooplankton-derived suspended particulate matter in summer along a transect in Baffin Bay (Arctic Ocean). (PubMed, Sci Total Environ) - "Lipid analyses confirmed the dominance of diatoms in the bottommost layer of ice and suggested (i) the presence of a strong proportion of micro-zooplankton in SPM samples collected at the western ice covered St 403 and St 409 and (ii) a high proportion of macro-zooplankton (copepods) in SPM samples collected at the eastern ice covered St 413 and open water St 418...The high trans/cis ratios also observed in SPM samples collected in the shallower waters at St 413 and St 418 suggest the presence of positively or neutrally buoyant extracellular polymeric substances (EPS)-rich particles retained in sea ice and discharged (with bacteria stressed by salinity) in seawater after the initial release of algal biomass. Such EPS particles, which are generally considered as ideal vectors for bacterial horizontal distribution in the Arctic, appeared to contain a high proportion of dead and non-growing bacteria."

Journal

[VIRTUAL] ST403. Pediatric Difficult Airway Management: Controversies and Tips for Success (ASA 2020) - "Session Learning Objective 4 Compare the efficacy of videolaryngoscopy to fiberoptic intubation through a supraglottic airway in children with a difficult airway. Session Learning Objective 5 Summarize the critical steps during fiberoptic intubation via a supraglottic airway device."

Clinical • Pediatrics