Background/Objectives: Body Protection Compound-157 (BPC 157) is a stable gastric pentadecapeptide with cytoprotective, pro-angiogenic, and nitric oxide (NO)-modulating properties that has gained increasing attention for its therapeutic potential. Although vasodilatory effects have been demonstrated in animal models, functional evidence in human arterial tissue remains limited. This study investigated the effects of BPC 157 on vascular tone in human internal mammary artery (IMA) rings and evaluated the contribution of endothelial NO signaling. Methods: Residual IMA segments obtained from elective coronary artery bypass graft surgeries (n = 12) were dissected into endothelium-intact and endothelium-denuded rings. Following equilibration, the rings were challenged by phenylephrine (PheE; 3 × 10⁻⁶ M) to induce contraction. Cumulative concentration–response curves of BPC 157 (0.01–1 mg/mL) for five consecutive doses were constructed. The involvement of NO was assessed by BPC 157 dose–response curves in the nitric oxide synthase (NOS) inhibitor Nω-nitro-L-arginine methyl ester (L-NAME; 10⁻⁶ M) pre-incubated rings. Maximum force of contraction, area under the curve, maximum response (Emax), and negative logarithm of the half-maximal effective concentration (pEC50) values were analyzed. Results: BPC 157 produced a concentration-dependent reduction in PheE-induced contraction in both groups, with significantly greater relaxation in endothelium-intact rings (p < 0.05). L-NAME increased contractile responsiveness in intact rings and attenuated BPC 157-induced relaxation. Under NOS inhibition, differences between groups progressively diminished and concentration–response curves converged at higher concentrations. Emax analysis demonstrated that endothelial integrity markedly enhanced maximal vasorelaxation, whereas this advantage was largely abolished after NOS inhibition. Conclusions: BPC 157 induces concentration-dependent vasorelaxation in human arterial tissue, predominantly mediated via an endothelium-dependent NO pathway. Endothelial integrity primarily enhances maximal efficacy, while residual effects indicate additional mechanisms. These findings provide early mechanistic evidence for the vascular activity of BPC 157, although further molecular and in vivo studies are required to clarify its clinical relevance.

Background/Objectives: Acute hypoxemic respiratory failure is a significant condition commonly seen in intensive care units (ICUs), yet specific prognostic markers related to it for mortality remain largely unstudied. This study aimed to identify parameters that influence mortality in ICU patients diagnosed with type 1 respiratory failure. Methods: A retrospective cohort study was conducted at a tertiary care hospital, including patients admitted to the ICU between March 2016 and March 2020. The study included patients with type 1 respiratory failure, while exclusion criteria were prior long-term respiratory support, type 2 respiratory failure, and early mortality (<24 h). Data on demographics, comorbidities, support requirements, laboratory values, and ICU scoring systems (APACHE II, SOFA, SAPS II, NUTRIC) were collected. Binomial regression analysis was used to determine independent predictors of 30-day mortality. Results: Out of 657 patients screened, 253 met the inclusion criteria (mean age 70.6 ± 15.6 years; 65.6% male). Non-survivors (n = 131) had significantly higher CCI scores; greater vasopressor requirements; and elevated SAPS II, APACHE, SOFA, and NUTRIC scores. Laboratory findings indicated higher inflammatory markers and lower nutritional markers (albumin and prealbumin, respectively) among non-survivors. In the regression model, SAPS II (OR: 13.38, p = 0.003), the need for inotropic support (OR: 1.11, p = 0.048), NUTRIC score (OR: 2.75, p = 0.014), and serum albumin (inverse; OR: 1.52, p = 0.001) were independently associated with mortality. The model had an AUC of 0.926 and classified 83.2% of cases correctly. When combined, SAPS II and mNUTRIC had more AUC compared to either standalone scoring. Conclusions: SAPS II, vasopressor requirements, mNUTRIC score, and low serum albumin are independent predictors of 30-day mortality in patients with acute hypoxemic respiratory failure. These findings support the integration of nutritional assessment, a combination of available scoring systems and comprehensive scoring into routine ICU evaluations for this patient group.

Background: Intraoperative hypotension is an established risk factor for postoperative acute kidney injury (AKI), but whether arterial waveform morphology adds prognostic information beyond the hypotension burden is unknown. Methods: In this study, 2587 adult surgical cases from the Vital Signs Database (VitalDB) with continuous invasive arterial waveforms and creatinine-based (KDIGO) AKI ascertainment were analyzed retrospectively. Maximal systolic upstroke (dP/dtmax), a late-diastolic pressure-decay descriptor (τ), and a waveform-derived dynamic arterial elastance (Eadyn), modeled as latent-class trajectories and as case-level features, were added to a base logistic model of log-transformed hypotension burden (time-weighted MAP < 65 mmHg), age, sex, and baseline eGFR. Results: AKI occurred in 143 cases (5.5%); the base model had an AUC of 0.725 (95% CI 0.680–0.770). A five-class dP/dtmax solution yielded distinct phenotypes whose membership was nominally associated with AKI (likelihood-ratio p = 0.02) but did not improve discrimination (change in AUC (ΔAUC), 0.008, 95% CI −0.005 to 0.021; optimism-corrected 0.002), and the association was attenuated after clinical adjustment (p = 0.13); τ showed no stable trajectory structure. No feature improved discrimination: the optimism-corrected ΔAUC was ≤0.007, upper confidence limits did not exceed 0.03 on any adequately fitting reference model, and the signal disappeared after adjustment for procedure type and comorbidity. The likelihood-ratio test had 80% power for a ΔAUC of 0.009. Conclusions: Arterial waveform morphology did not improve prediction of postoperative AKI beyond the hypotension burden; overall, these data exclude an incremental gain larger than approximately 0.02–0.03 AUC units.

Background: Standard predictors (Mallampati score, Wilson Risk Score, airway measurements) validated for single-lumen tubes might not apply to double-lumen tubes (DLT). The aim of this study is to evaluate whether these predictors can identify challenging DLT intubations. Material and methods: In this prospective study, 200 adult patients undergoing elective thoracic surgery and intubated with DLT were enrolled. Preoperative airway assessments included Mallampati score, Wilson Risk Score, Cormack–Lehane Classification Score (CLS), body mass index (BMI), neck circumference (NC), neck and head mobility, Interincisor distance (IID), Sternomental distance (SMD), thyromental distance (TMD), and the ratio of height to TMD (RHTMD), as well as the NC to TMD ratio were performed. Intubation difficulty was measured using the Intubation Difficulty Scale (IDS). Based on IDS, patients were grouped as easy or difficult intubation, and the effectiveness of the criteria mentioned above in predicting intubation difficulty was assessed. Results: Intubation difficulties occurred in 36 out of 200 patients (18%). There were no significant demographic differences between the easy and difficult intubation groups. The difficult intubation group showed higher Mallampati, Wilson, and CLS scores. They also had shorter SMD and TMD, smaller IIDs, and a higher height-to-TMD ratio ( p < 0.01). New DLT-specific cut-off values (SMD 15 cm, TMD 8 cm, IID 3.5 cm) were established. Only the Cormack-Lehane grade independently predicted difficulty. Patients with difficult intubation required additional interventions. Other measures differed between groups but lost significance in regression analysis. Conclusion: The Cormack–Lehane grade was the only independent predictor of difficulty in intubation with DLT. The new DLT-specific cutoff values suggest that DLT intubation might require its own customized assessment criteria. The proposed new cutoff values could make risk stratification more accurate. Combining scoring and measurements may improve preparation for difficult DLT intubations.

Background: Migraine is a neurological disorder affecting approximately 15% of the general population, and autonomic nervous system (ANS) dysfunction is a well-characterized feature of the condition. Sympathovagal imbalance during acute migraine attacks has been linked to cardiac electrical instability. This study aimed to evaluate atrial and ventricular myocardial repolarization markers in migraine patients at three serial electrocardiography (ECG) time points. Methods: A prospective observational cross-sectional study was conducted in a tertiary emergency department (ED), enrolling 70 migraine patients and 70 age- and sex-matched healthy controls. Three 12-lead ECGs were obtained per patient: during the migraine attack (within 60 min of ED admission), after analgesic treatment (verbal pain relief or Numeric Rating Scale [NRS] decrease greater than 4 points), and in the pain-free period (at least 24 h after the attack, within 7 days). Measured parameters included P-wave duration, P-wave dispersion, QT interval, QT dispersion, corrected QT (QTc) duration (Bazett formula), QTc dispersion, Tpeak–Tend (Tp-e) interval, Tp-e dispersion, and Tp-e/QTc ratio. ECGs were evaluated by two blinded emergency medicine specialists. Results: All repolarization markers were significantly higher in migraine patients than in controls (p < 0.05 for all). Comparing the first (ictal) with the second (post-treatment) measurements, all markers except P-wave dispersion decreased significantly (p < 0.05). All markers were significantly higher during the attack than in the pain-free period (p < 0.05 for all). Tp-e interval and Tp-e/QTc ratio showed a further significant reduction between the second and third measurements (p = 0.016 and p = 0.004, respectively). P-wave dispersion was significant only for the first-to-second comparison (p = 0.034) and did not differ significantly between the first and third (p = 0.137) or second and third (p = 0.725) measurements. Pulse rate was significantly higher in the migraine group than in controls (p = 0.012). Conclusions: Acute migraine attacks were associated with significant elevation of both atrial and ventricular repolarization markers, with near-normalization during pain-free periods. These findings are consistent with a proposed mechanism of ANS-mediated cardiac electrical instability during acute attacks, although direct confirmation in future studies is required. Clinicians managing acute migraine in the ED should consider ECG monitoring in patients with cardiovascular risk factors. For anesthesiologists and intensivists, the elevated Tp-e and Tp-e/QTc observed ictally indicate that preoperative ECG assessment in migraine patients may be warranted to guide anesthetic planning.