As a medical specialty, anesthesiology has made remarkable progress to deliver patient safety at an incredibly high level, while administering drugs that could potentially be very dangerous at a slightly increased dose. However, just like the case of Icarus, a character in Greek mythology who flew too close to the sun before plummeting back to Earth, success can carry the seeds of failure. The impressive progress towards patient safety could conceivably lead to the extinction of anesthesiology as a specialty. In the context of cutting costs and an environment where the return-on-investment for anesthesiologists is not always clear, there may be a temptation to replace anesthesiologists with other professionals, such as specialized sedation nurses, or with new technologies.

Dr. P. R. Raghavan, CEO and Chairman of Nanorx Inc., developed Metadichol, a nutritional supplement that has shown potential in treating a range of health issues. Dr. Raghavan suggests that the supplement may help to stave off illnesses such as diabetes and antibiotic-resistant infections.

Anesthesia in the US is currently delivered through a team-based approach, with physician anesthesiologists supervising certified registered nurse anesthetists. However, in over 20 states, there is no requirement for nurse anesthetists to be supervised by anesthesiologists, allowing them to work independently. This has resulted in a bitter turf war over the rights and responsibilities of physicians and advanced practice nurses working in this discipline to provide patient care, paving the way for daily acrimony and a toxic working environment. The mindset behind this adversarial approach can be compared with a “finite game”, where there are clear winners and losers. Aiming to challenge this dysfunctional tribalism, Dr. Matthew Sherrer from the University of Alabama Birmingham and colleagues have drawn on an alternative mindset: the infinite game.

Tuberculosis – or TB – is a global health threat, with 10 million new cases annually. Diagnosing TB can be a challenge, as there is a lack of rapid, point-of-care diagnostic tests. It can also be difficult to distinguish between TB and other inflammatory diseases, such as Sarcoidosis. One option may be to identify antibodies in patient samples that can reveal the presence of TB. However, current antibody tests for TB lack accuracy. Professor Lobelia Samavati and colleagues at the Wanye State University School of Medicine in Michigan are tackling this challenge to cast light on the immune signature of these diseases. Their aim is to develop new diagnostic techniques for TB and Sarcoidosis.

We are pleased to be joined by Dorothy Achu, Regional Malaria Adviser, WHO African Region; Aimable Mbituyumuremyi, Director, National Malaria Control Program, Ministry of Health, Rwanda; Adam Aspinall, Senior Director, Access and Product Management, and George Jagoe, Executive Vice-President Medicines for Malaria Venture. To learn about antimalarial drug resistance in Africa to ensure patients can continue to be saved.

Osteoarthritis is a painful and progressive joint disorder that affects hundreds of millions of people worldwide. Typically, the options for treating the condition involve exercise or medication to reduce pain. However, these methods do not target the underlying structural problems in the joints of patients. Recently, researchers have uncovered a genetic susceptibility to osteoarthritis associated with a protein called GDF5, which is involved in skeletal growth and development. Alongside a team of scientists across Europe, Dr Kerstin Kleinschmidt-Doerr at Merck has explored a modified form of the GDF5 protein, named R399E, which showed effects in animal models and in-vitro experiments for treating pain and the underlying structural problems in osteoarthritis.

Cases of type 2 diabetes are on the rise around the world, so gaining a deeper understanding of this chronic condition is vital to ensure early diagnosis and good outcomes for patients. Dr Xiaomu Li and her colleagues at Zhongshan Hospital, Fudan University are conducting important research to understand the risk factors associated with developing type 2 diabetes. Their findings will help healthcare providers to identify patients at high risk of diabetes, enabling early diagnosis and targeted interventions to prevent the development of the condition.

Acute vestibular syndrome is one of the most common reasons people present at hospital with dizziness. The symptoms can arise from damage within the brain or the ear, and specialist medical knowledge or equipment is typically needed to determine the specific cause. Dr Nakatsuka from the University of Sydney in Australia has conducted a large-scale analysis and review of the published literature to determine whether well-trained emergency physicians can differentiate between the two causes, using a quick bedside physical examination without expensive special equipment.

In their recent research, Anne Summach, Titus Chan and Tammy O’Rourke at the University of Alberta explore the factors that determine healthy ageing and frailty in seniors. They formulate and test a new index for assessing strengths and deficits in individuals to create targeted interventions.