Objective: The negative effects of delirium in intensive care unit (ICU) patients necessitate the identification and management of risk factors. This study aimed to determine the incidence of delirium and its associated modifiable and non-modifiable factors in the ICU setting to provide valuable insights for better patient care and outcomes. Methods: Patients admitted to the ICU underwent delirium screening twice daily. Comprehensive records of modifiable and non-modifiable risk factors were maintained throughout the ICU stay. Results: The incidence of delirium was 32.5%. Age [odds ratio (OR) 1.04, confidence interval (CI) 1.02-1.06, P < 0.001)]. Illiteracy (OR 4, CI 1.19-13.35, P=0.02), hearing impairment (OR 3.37, CI 1.71-7.01, P=0.001), visual impairment (OR 3.90, CI 2.13-7.15, P < 0.001), hypertension (OR 2.56, CI 1.42-4.62, P=0.002), Sequential Organ Failure Assessment score (OR 1.21, CI 1.08-1.36, P=0.001), Acute Physiology and Chronic Health Evaluation II score (OR 1.20, CI 1.12-1.28, P < 0.001), presence of a nasogastric catheter/drain (OR 2.15, CI 1.18-3. 90, P=0.01), tracheal aspiration (OR 3.63, CI 1.91-6.90, P < 0.001), enteral nutrition (OR 2.54, CI 1.12-5.76, P=0.02), constipation (OR 1.65, Cl 1.11-2.45, P=0.02), oliguria (OR 1.56, Cl 1.06-2.28, P=0.02), midazolam infusion (OR 3. 4, Cl 1.16-10.05, P=0.02), propofol infusion (OR 2.91 Cl 1.03-8.19, P=0.04), albumin use (OR 2.39, Cl 1.11-5.14 P=0.02) and steroid use (OR 2.17, Cl 1.06-4.40, P=0.03) were found to be independent risk factors for delirium. Conclusion: This study highlights several risk factors contributing to delirium, such as age, sensory impairment, educational level, procedural interventions, and medications.Oral nutrition and mobilization are effective strategies for reducing delirium incidence in the ICU.

Background and Objectives: Sepsis and its related complications are associated with high morbidity and mortality, often leading to liver damage. Ozone, a molecule with anti-inflammatory and antioxidant properties, may offer protective effects. This study aimed to evaluate the therapeutic and protective impact of ozone on liver injury in a rat model of sepsis induced by cecal ligation and perforation (CLP). Material and Methods: A total of 36 rats were randomly divided into five groups: control (Group C), ozone (Group O), cecal ligation and perforation (Group CLP), ozone + cecal ligation and perforation (Group O+CLP), and cecal ligation and perforation + ozone (Group CLP+O). In the ozone groups, 4 mL of ozone (20 µ/mL) was injected intraperitoneally. Biochemical and histopathological parameters were evaluated in liver tissue samples obtained at the end of 24 h. Results: Polymorphonuclear leukocyte and monocyte infiltration and the total injury score were significantly reduced in the ozone-treated groups compared to the CLP group (p < 0.001). Tumor necrosis factor and interleukin 10 levels in the rat liver tissue were significantly reduced in the O+CLP and CLP+O groups compared to the CLP group, with the O+CLP group showing a more substantial decrease than the CLP+O group (p < 0.001). Thiobarbituric acid reactive substances and glutathione s-transferase levels were significantly lower in the ozone-treated groups compared to the CLP group (p < 0.001). Catalase activity was significantly elevated in the O+CLP group compared to the CLP group (p < 0.001). Serum aspartate transaminase, alanine transaminase, gamma-glutamyl transferase, and total bilirubin were significantly increased in the CLP group and decreased in the ozone-treated groups (p < 0.001, p < 0.001, p = 0.01, p < 0.001 respectively). Conclusions: Administering ozone to rats one hour before the CLP significantly mitigated liver damage, showing a more pronounced effect compared to administering ozone one hour after CLP. The results indicate that ozone could serve a protective function in managing sepsis-induced liver damage.

Background and Objectives: Lower-extremity ischemia–reperfusion injury can induce distant organ ischemia, and patients with diabetes are particularly susceptible to ischemia–reperfusion injury. Sevoflurane, a widely used halogenated inhalation anesthetic, and fullerenol C60, a potent antioxidant, were investigated for their effects on heart and lung tissues in lower-extremity ischemia–reperfusion injury in streptozotocin (STZ)-induced diabetic mice. Materials and Methods: A total of 41 mice were divided into six groups: control (n = 6), diabetes–control (n = 7), diabetes–ischemia (n = 7), diabetes–ischemia–fullerenol C60 (n = 7), diabetes–ischemia–sevoflurane (n = 7), and diabetes–ischemia–fullerenol C60–sevoflurane (n = 7). Diabetes was induced in mice using a single intraperitoneal dose of 55 mg/kg STZ in all groups except for the control group. Mice in the control and diabetes–control groups underwent midline laparotomy and were sacrificed after 120 min. The DIR group underwent 120 min of lower-extremity ischemia followed by 120 min of reperfusion. In the DIR-F group, mice received 100 μg/kg fullerenol C60 intraperitoneally 30 min before IR. In the DIR-S group, sevoflurane and oxygen were administered during the IR procedure. In the DIR-FS group, fullerenol C60 and sevoflurane were administered. Biochemical and histological evaluations were performed on collected heart and lung tissues. Results: Histological examination of heart tissues showed significantly higher necrosis, polymorphonuclear leukocyte infiltration, edema, and total damage scores in the DIR group compared to controls. These effects were attenuated in fullerenol-treated groups. Lung tissue examination revealed more alveolar wall edema, hemorrhage, vascular congestion, polymorphonuclear leukocyte infiltration, and higher total damage scores in the DIR group compared to controls, with reduced injury parameters in the fullerenol-treated groups. Biochemical analyses indicated significantly higher total oxidative stress, oxidative stress index, and paraoxonase-1 levels in the DIR group compared to the control and diabetic groups. These levels were lower in the fullerenol-treated groups. Conclusions: Distant organ damage in the lung and heart tissues due to lower-extremity ischemia–reperfusion injury can be significantly reduced by fullerenol C60.

Objective: Pancreatic surgeries inherently cause ischemia-reperfusion (IR) injury, affecting not only the pancreas but also distant organs. This study was conducted to explore the potential use of dexmedetomidine, a sedative with antiapoptotic, anti-inflammatory, and antioxidant properties, in mitigating the impacts of pancreatic IR on kidney and liver tissues. Methods: A total of 24 rats were randomly divided into four groups: control (C), dexmedetomidine (D), ischemia reperfusion (IR), and dexmedetomidine ischemia reperfusion (D-IR). Pancreatic ischemia was induced in the IR and D-IR groups. Dexmedetomidine was administered intraperitoneally to the D and D-IR groups. Liver and kidney tissue samples were subjected to microscopic examinations after hematoxylin and eosin staining. The levels of thiobarbituric acid reactive substances (TBARS), aryllesterase (AES), catalase (CAT), and glutathione S-transferase (GST) enzyme activity were assessed in liver and kidney tissues. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine were measured. Results: A comparison of the groups revealed that the IR group exhibited significantly elevated TBARS (p < 0.0001), AES (p = 0.004), and CAT enzyme activity (p < 0.0001) levels in the liver and kidney compared to groups C and D. Group D-IR demonstrated notably reduced histopathological damage (p < 0.05) and low TBARS (p < 0.0001), AES (p = 0.004), and CAT enzyme activity (p < 0.0001) in the liver and kidney as well as low AST and ALT activity levels (p < 0.0001) in the serum compared to the IR group. Conclusion: The preemptive administration of dexmedetomidine before pancreatic IR provides significant protection to kidney and liver tissues, as evidenced by the histopathological and biochemical parameters in this study. The findings underscored the potential therapeutic role of dexmedetomidine in mitigating the multiorgan damage associated with pancreatic surgeries.

The emergence of artificial intelligence (AI)-based linguistic models has revolutionized academic writing, prompting concerns about integrity. In response, AI-powered text authenticity detectors have been developed. This study examines AI tool usage in anesthesiology and intensive care journals. 1268 articles from 86 journals in “Anesthesiology” and “Anesthesiology and Intensive Care” were analyzed using Copyleaks and ZeroGPT. English abstracts published between April 18 and May 18, 2023, were scrutinized. ZeroGPT and Copyleaks found average AI usage at 25.1% ± 27.5 and 10.5% ± 15.9, respectively. 16.8% of articles were “human-written,” while 83.2% were “AI-assisted”. AI assistance correlated positively with abstract length and was more common among nonnative English speakers (P < .001). It was also prevalent in high-impact and science citation index-indexed journals (P < .01; P < .001). This study underscores the widespread adoption of AI tools in academic writing, particularly among nonnative English authors and in high-impact journals, emphasizing the need for improved detection mechanisms and regulatory guidelines.

Background: Existing studies on anesthesiologists’ attitudes toward artificial intelligence (AI) leave a global understanding underexplored. This cross-sectional study aims to investigate Turkish anesthesiologists’ attitudes toward AI, examining its perceived benefits, limitations, and associated ethical concerns. Insights from this study aim to enhance understanding of AI’s role in anesthesiology within a cultural and ethical context. Methods: This nationwide study surveyed Turkish anesthesiologists. Descriptive statistics summarized categorical variables, Pearson’s Chi-square test compared variables between groups. Binary logistic regression analyzed associations between demographic factors and positive attitudes toward AI. Results: Among 293 valid responses, 69.6% of participants expressed positive attitudes toward AI. Gender ( P = 0.01), employment setting ( P < 0.001), and prior AI experience ( P < 0.001) were significant predictors of positive attitudes. AI applications most frequently endorsed included preoperative assessments (93.1%), academic support (95.2%), and medical education (91.2%). Ethical concerns were prominent, with liability ambiguity (87.3%) and privacy issues (62.8%) being the most cited. Logistic regression revealed that participants aged 46–55 were significantly more likely to exhibit positive attitudes (OR = 3.744, P = 0.03), while those with over 15 years of experience were less likely to do so (OR = 0.105, P = 0.04). Conclusions: Turkish anesthesiologists exhibited predominantly positive attitudes toward AI, with prior experience playing a significant role in shaping perceptions. While AI was embraced for academic, educational, and noninvasive tasks, skepticism was present toward its application in invasive procedures. These findings highlight AI’s potential to enhance efficiency and patient safety while underscoring the need for comprehensive legal and ethical frameworks.