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stress response to surgery

Elise Chia-Hui Tan, Duan-Rung Chen
PURPOSE: The health of physicians can have a strong impact on the quality and safety of the health care they provide. Studies have shown a link between work stress, burnout, and depression. The aim of this study was to examine the association between malpractice dispute experiences and the well-being of physicians. METHODS: We conducted a cross-sectional survey to collect information about the malpractice experiences of primary care physicians in 2004. Data on sociodemographic and clinical characteristics and SF-36 measures were also collected...
August 14, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Güler Ayşe Barut, Mehtap Tunç, Şaziye Şahin, Fatma Ulus, Hilal Sazak
Background/aim: This study aims to investigate the effects of thoracic epidural analgesia, before and after surgical incision and in the postoperative period, on thoracotomy pain and stress response. Materials and methods: A total of 45 patients who were scheduled for posterolateral thoracotomy were included in this study. A combination of epidural levobupivacaine and morphine was administered as a bolus before incision (Group 1; n=15), after incision (Group 2; n=15), or at the end of surgery (Group 3; n=15)...
August 16, 2018: Turkish Journal of Medical Sciences
ZuoXia Zhang, Hao Wu, Yue Liu, XiaoPing Gu, Wei Zhang, ZhengLiang Ma
BACKGROUND: Patients undergoing surgery often feel anxious. Accumulating evidence indicated that presurgical anxiety was related to the more severe postsurgical pain. An animal model was established that exposed Sprague-Dawley rats to a single-prolonged stress (SPS) procedure to induce presurgical anxiety-like behaviors. The experiment revealed that presurgical anxiety not only aggravated but also prolonged postsurgical pain. However, the underlying mechanisms were unknown. METHODS: The rats in group C + Cort, group I + Cort, group A + Cort, and group AI + Cort were injected with corticosterone...
August 14, 2018: Anesthesia and Analgesia
Ahmed Abdelaal Ahmed Mahmoud, Mark Campbell, Margarita Blajeva
The current case report represents a warning against serious hyperkalaemia and acidosis induced by ACE-I during surgical stress while normal renal function could deceive the attending anaesthetist. Arterial gas analysis for follow-up of haemoglobin loss accidentally discovered hyperkalaemia and acidosis. Glucose-insulin and furosemide successfully corrected hyperkalaemia after 25 minutes and acidosis after 3 hours. These complications could be explained by a deficient steroid stress response to surgery secondary to suppression by ACE-I...
2018: Case Reports in Anesthesiology
Ping-Chen, Qing-Song Lin, Xian-Zhong Lin
Objective The transversus abdominis plane (TAP) block ameliorates visual analogue scale scores and decreases morphine requirements, but its role remains unclear. Patients of advanced age are susceptible to local anesthetic intoxication. We aimed to identify an optimal concentration that can be used in enhanced recovery after surgery (ERAS) without compromising analgesic efficacy. Methods In total, 120 patients aged ≥65 years undergoing laparoscopic rectal cancer surgery received general anesthesia combined with a TAP block using 0...
August 15, 2018: Journal of International Medical Research
Yangfan Xiao, Lezhi Li, Yijia Xie, Junmei Xu, Yan Liu
To investigate the effect of the aroma therapy and music intervention on anxious and pain for the breast cancer patients in the perioperative period and the potential mechanisms.
 Methods: A total of 100 breast cancer patients who received surgical treatment in the comprehensive hospitals of Hunan province were recruited for this study. Patients were assigned randomly into a control group, an aroma therapy group, a music intervention group, and a joint-therapy group (n=25 per group). The patients in the control group received regular post-surgical nursery, while the patients from other groups received aroma therapy, music intervention, or both in addition to the regular nursery...
June 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Francisco Adelvane de Paulo Rodrigues, Alan Diego da Conceição Santos, Pedro Henrique Quintela Soares de Medeiros, Mara de Moura Gondim Prata, Tailane Caína de Souza Santos, James Almada da Silva, Gerly Anne de Castro Brito, Armênio Aguiar Dos Santos, Edilberto Rocha Silveira, Aldo Ângelo Moreira Lima, Alexandre Havt
Acute kidney injury (AKI) and metabolic dysfunction are critical complications in sepsis syndrome; however, their pathophysiological mechanisms remain poorly understood. Therefore, we evaluated whether the pharmacological properties of 6-gingerol (6G) and 10-gingerol (10G) could modulate AKI and metabolic disruption in a rat model of sepsis (faecal peritonitis). Animals from the sham and AKI groups were intraperitoneally injected with 6G or 10G (25 mg/kg). Septic AKI decreased creatinine clearance and renal antioxidant activity, but enhanced oxidative stress and the renal mRNA levels of tumour necrosis factor-α, interleukin-1β, and transforming growth factor-β...
August 14, 2018: Scientific Reports
Ana Claudia Weck Roxo, Carlos Del Pino Roxo, Ruy Garcia Marques, Nadia Cristina Pinheiro Rodrigues, Diego Vigna Carneiro, Francisco Mateus Dantas Carneiro Souto, Fabio Xerfan Nahas
Background: The endocrine-metabolic response to trauma is directly related to its magnitude, but little is known about the adverse effects of combined surgical procedures on morbidity. Objective: To evaluate risk factor in patients undergoing multiple body contouring surgeries after massive weight loss by measuring the endocrine-metabolic response. Methods: This prospective, randomized, interventional study included 46 massive weight loss patients with a weight loss higher than 30% of their (body mass index) BMI, who were referred for body contouring surgery...
August 10, 2018: Aesthetic Surgery Journal
S Utku Ünal, Emre Kubat, Başak Soran Türkcan, Erman Kiriş, Aslı Demir, Bahadır Aytekin, Boğaçhan Akkaya, Uğur Aksu, Ayşen Aksöyek
BACKGROUND: Antegrade cerebral perfusion (ACP) is the standard neuroprotection method in aortic surgery. Visceral ischemia during this modality brings out some controversies. We aimed to investigate the level of oxidative stress at the lower part of body during ACP. METHODS: Thirty consecutive patients underwent elective ascending aorta and hemiarch repair with ACP (without distal perfusion) were enrolled to study. The patients were enrolled into two groups which were based on 50th percentile of ACP duration (15 patients in each group)...
August 14, 2018: Acta Chirurgica Belgica
Sara Anne Ruggiero, Jason Huber, Coral L Murrant, Keith R Brunt, Jeremy Andrew Simpson
During physiological stress (e.g. exercise, hypoxia) blood flow is shunted to specific anatomical regions to protect critical organs, yet, splenic blood flow in these circumstances remains to be investigated. Despite being classically viewed as a non-critical organ, recent experimental and epidemiological evidence suggests the spleen plays a significant role in cardiovascular pathophysiology. We hypothesized that splenic blood flow is prioritized in the development of heart failure (i.e. chronic state of reduced cardiac output)...
August 13, 2018: Canadian Journal of Physiology and Pharmacology
Hiroharu Kataoka, Yasuhide Makino, Kiyofumi Takanishi, Yohei Kimura, Kenji Takamura, Takanobu Yagi, Satoshi Iguchi, Akihide Yamamoto, Hidehiro Iida, Soshiro Ogata, Kunihiro Nishimura, Masanori Nakamura, Mitsuo Umezu, Koji Iihara, Jun C Takahashi
BACKGROUND: Bypass surgery for complex intracranial aneurysms (IAs) results in drastic blood flow changes in intracranial arteries. The aim of the study was to elucidate how vessels adapt to blood flow changes after bypass surgery with phase-contrast magnetic resonance imaging (PC-MRI). METHODS: This is a prospective observational study to assess changes of the blood flow in intracranial arteries after bypass surgery for IAs. Flow rates and vessel diameters were measured with PC-MRI in 52 intracranial arteries of 7 healthy volunteers and 31 arteries of 8 IA patients who underwent bypass surgery...
August 13, 2018: Acta Neurochirurgica
Maxime Rossi, Sandrine Delbauve, Eric Wespes, Thierry Roumeguère, Oberdan Leo, Véronique Flamand, Alain Le Moine, Jean-Michel Hougardy
Acute kidney injury (AKI) is a major public health concern, which is contributing to serious hospital complications, chronic kidney disease (CKD) and even death. Renal ischemia-reperfusion injury (IRI) remains a leading cause of AKI. The stress-responsive enzyme, heme oxygenase-1 (HO-1) mediates protection against renal IRI and may be preventively induced using hemin prior to renal insult. This HO-1 induction pathway called hemin preconditioning is largely known to be effective. Therefore, HO-1 might be an interesting therapeutic target in case of predictable AKI (e...
August 9, 2018: Biochemical and Biophysical Research Communications
Kaven Baessler, Alexandra Mowat, Christopher F Maher
INTRODUCTION AND HYPOTHESIS: The aim of this study was to establish the minimal important difference (MID) of the Australian Pelvic Floor Questionnaire (APFQ) in women undergoing surgery for stress urinary incontinence or symptomatic pelvic organ prolapse. A further aim was to estimate dysfunction scores dependent on the bothersomeness in a community cohort. METHODS: The APFQ was completed before and 6 weeks after pelvic floor surgery by 183 women (n = 80 suburethral tape insertion; n = 103 laparoscopic sacrocolpopexy)...
August 7, 2018: International Urogynecology Journal
Susan A Maroney, Julie A Peterson, Wes Zwifelhofer, Nicholas D Martinez, Ke Yan, Rachel S Bercovitz, Ronald K Woods, Alan E Mast
BACKGROUND:  Neonates undergoing cardiopulmonary bypass (CPB) surgery to correct congenital heart defects often experience excessive bleeding. Exposure of blood to artificial materials during CPB may activate coagulation, complement and inflammatory pathways. In addition, the surgical stress placed on the haemostatic system may result in cross-activation of other plasma proteolytic cascades, which could further complicate physiological responses to the surgical procedure and post-operative recovery...
August 7, 2018: Thrombosis and Haemostasis
Besem Beteck, William Shutze, Brad Richardson, Ryan Shutze, Kimberly Tran, Allan Dao, Gerald O Ogola, Greg Pearl
BACKGROUND: Neurogenic thoracic outlet syndrome (NTOS) is the most common form of TOS and may occur from injury, occupational stress or athletic endeavors. While most patients with NTOS will improve after first rib resection and scalenectomy (FRRS), the prognostic risk factors for success remain unclear. Athletes are a very motivated and disciplined demographic and therefore should be a group more likely to respond to FRRS for NTOS than non-athletes. We hypothesized that athletes would do better after FRRS than non-athletes despite the added physical stress that sporting activity imposes...
August 3, 2018: Annals of Vascular Surgery
Jacque A Crosson
Continued advancements in perioperative care and anesthesia technology have improved surgical outcomes and accelerated the patient's ability to resume preoperative activities. With the current emphasis on decreased utilization of expensive hospital resources, a shorter length of stay while maintaining patient satisfaction is encouraged for maximum reimbursement. Through the implementation of evidence-based protocols that standardize care and promote patient medical optimization, the surgical stress response, complications, and time spent in the hospital can be reduced...
August 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Zhiwen Wang, Ai Zhang, Weixin Meng, Tingting Wang, Dandan Li, Zonghong Liu, Hongyu Liu
Ischemia-reperfusion injury (IRI) is a major cause of lung dysfunction during cardiovascular surgery, heart transplantation and cardiopulmonary bypass procedures, and the inflammatory response, oxidative stress, and apoptosis play key and allegedly maladaptive roles in its pathogenesis. The aim of this study was to initially elucidate whether ozone induces oxidative preconditioning by activating nuclear factor (erythroid-derived 2)-like 2 (Nrf2) and secondly to determine whether ozone oxidative preconditioning (OzoneOP) protects the lung from IRI by attenuating nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3)-mediated inflammation, enhancing the antioxidant activity of Nrf2 and inhibiting apoptosis...
July 31, 2018: European Journal of Pharmacology
Sandro M Sgrott, Rodrigo D Neves, Armando J D'Acampora, Geraldo J S Bernardes, Luiz Belmonte, Thiago C Martins, Franciane Bobinski, Eduardo Cargnin-Ferreira, Andreza Hoepers, Clarissa M Comim, Daniel F Martins, Anna P Piovezan
Silicone breast implant is associated with complications inherent to the surgical procedure. Prosthesis coating with polyurethane, however, commonly reduces the incidence of such complications. In this paper, the authors evaluated the inflammatory histomorphometric profile and oxidative damage associated to the implant of polyester urethane sheets. Forty-eight Wistar rats were divided into Sham or polyester urethane groups (n = 8/group) and underwent a polyester urethane implant in the dorsal skinfold. Tissue samples were collected on days seven, 30, and 90 after surgery and subjected to histomorphometric analysis and biochemical tests...
July 26, 2018: Anais da Academia Brasileira de Ciências
Sandra Velcic Brumnjak, Ivan Rakovac, Dijana Papez Kinkela, Kresimir Bukal, Branko Sestan, Vera Tulic, Elisa Velcic Janjetic, Vlatka Sotosek Tokmadzic
BACKGROUND Pain and surgical stress cause a pro-inflammatory response followed by downregulation of the immune response, which can increase the incidence of postoperative complications, such as infections or prolonged wound healing. T lymphocytes and natural killer (NK) cells have cytotoxic potential and are crucial components of cellular immunity, which is important for maintenance of immune balance. The aim of this study was to analyze the effects of 3 types of postoperative analgesia on the preservation and cytotoxic potential of T lymphocytes, NK cells, and their subpopulations, as well as NKT cells, in patients after total knee replacement (TKR) to find the most effective analgesic technique for mitigating immune suppression...
July 31, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
P P Lunkenheimer, P Niederer, J M Lunkenheimer, K Redmann, M Smerup, B Schmitt, W Saggau, R J V Batista
In the hypertrophic heart the myostructural afterload in the form of endoepicardial networks is predominant, which enhances myocardial hypertrophy. The intrinsic antagonism is derailed. Likewise, the connective tissue scaffold, i.e. the stromatogenic afterload, is enriched in the response to the derailment of antagonism in a hypertrophic heart up to regional captivation of the heart musculature. Due to the selective susceptibility of the auxotonic, contracting oblique transmural myocardial network for low dose negative inotropic medication, this promises to attenuate progress in myocardial hypertrophy...
July 27, 2018: Herz
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