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Ketamine's rapid antisuicidal action has gathered significant clinical interest in treatment of depression though concerns exist that its actions occur through the Opioid pathway. A recent study additionally reported that Naltrexone blocks antisuicidal effects of Ketamine suggesting that its antisuicidal effects are also due to opioid mechanisms. We present a case of treatment refractory depression with recent suicide attempt and active suicidal ideations who was on an Opioid partial agonist, Buprenorphine, for management of pain. Patient responded to a trial of IV ketamine treatment with rapid improvement in suicidal thoughts. Patient's suicidal ideations decreased after first Ketamine treatment and resolved after second treatment while maintained on Buprenorphine. Our finding shows that Buprenorphine does not block Ketamine's effects on suicidal ideations and therefore Ketamine treatment could be provided safely in controlled environment to those with substance use disorders or with chronic pain while being maintained on Buprenorphine. Additionally, our case suggests that non-Opioid mechanisms may be involved in Ketamine's antidepressant effects and its response to suicidal ideations in those on Opioid partial agonists.

We sought to describe the intracoronary near-infrared spectroscopy (NIRS) findings in survivors of sudden cardiac arrest. Sudden cardiac death remains a major public health problem. Autopsy studies have established that sudden death is often attributable to rupture of an intracoronary lipid core

A maximum lipid core burden index in 4-mm (maxLCBI4mm) ≥400 has been suggested to be a near-infrared spectroscopy (NIRS) signature of plaques that cause myocardial infarction, yet little is known about the fibrous cap thickness of lesions having such a large lipid burden. The present study was