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https://www.readbyqxmd.com/read/28526152/pharmacologic-properties-of-novel-local-anesthetic-agents-in-anesthesia-practice
#1
REVIEW
Chih H King, Sascha S Beutler, Alan D Kaye, Richard D Urman
Therapeutic duration of traditional local anesthetics when used in peripheral nerve blocks is normally limited. This article describes novel approaches to extend the duration of peripheral nerve blocks currently available or in development. Three newer approaches on extending the duration of peripheral nerve blocks include site-1 sodium channel blockers, novel local anesthetics delivery systems, and novel adjuvants of local anesthetics. Compared with plain amide-based and ester-based local anesthetics, alternative approaches show significant promise in decreasing postoperative pain, rescue opioid requirement, hospital length-of-stay, and overall health care cost, without compromising the established safety profile of traditional local anesthetics...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28525514/perineural-dexmedetomidine-is-more-effective-than-clonidine-when-added-to-local-anesthetic-for-supraclavicular-brachial-plexus-block-a-systematic-review-and-meta-analysis
#2
Kariem El-Boghdadly, Richard Brull, Herman Sehmbi, Faraj W Abdallah
BACKGROUND: Clonidine, an α-2 agonist, has long been used as a local anesthetic adjunct with proven efficacy to prolong peripheral nerve block duration. Dexmedetomidine, a newer α-2 agonist, has a more favorable pharmacodynamic and safety profile; however, data comparing its efficacy as an adjunct to that of clonidine are inconsistent. We sought to compare the clinical efficacy of these 2 α-2 agonists by examining their effects on peripheral nerve block characteristics for upper extremity surgery...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28522768/a-model-for-in-vivo-analysis-of-sudomotor-sympathetic-c-fiber-activation-and-human-sweat-gland-output
#3
Gary W Mack
Quantitative assessment of small fiber peripheral neuropathy often involves an evaluation of the interaction between the C-fiber sudomotor nerve and local sweat rate (SR). Typically, some sort of quantitative sudomotor axon reflex test (QSART) is performed to aid in diagnosing small fiber dysfunction. The currently used QSART demonstrates only moderate test-retest reliability and therefore limits its usefulness in tracking small fiber dysfunction. A new experimental model to examine small C-fiber function in the skin using intradermal electrical stimulation and simultaneous monitoring of SR is proposed...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28522736/myelin-associated-glycoprotein-mag-inhibits-schwann-cell-migration-and-induces-their-death
#4
Nagarathnamma Chaudhry, Corinne Bachelin, Violetta Zujovic, Melissa Hilaire, Katherine T Baldwin, Rose M Follis, Roman Giger, Bruce D Carter, Anne Baron-Van Evercooren, Marie T Filbin
Remyelination of central nervous system (CNS) axons by Schwann cells (SC) is not efficient, in part due to their poor migration into the adult CNS. Although it is known that migrating SC avoid white matter tracts, the molecular mechanisms underlying this exclusion has never been elucidated. We now demonstrate that myelin-associated glycoprotein (MAG), a well-known inhibitor of neurite outgrowth, inhibits rat SC migration and induces their death via γ secretase-dependent regulated intramembrane proteolysis (RIP) of the p75 neurotrophin receptor (also known as p75 cleavage)...
May 17, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28515278/critical-role-of-p2y12-receptor-in-regulation-of-th17-differentiation-and-experimental-autoimmune-encephalomyelitis-pathogenesis
#5
Chaoyan Qin, Jinfeng Zhou, Yuan Gao, Weiming Lai, Cuixia Yang, Yingying Cai, Shuai Chen, Changsheng Du
Adenosine 5'-diphosphate is a key endogenous cell-signaling molecule that can activate P2 purinergic receptor family members. ADP-P2Y signaling is reported to be associated with inflammation, but its function in T cell differentiation and autoimmune diseases pathogenesis is unclear. In this study, we found that the P2Y12 receptor was upregulated in the peripheral immune tissues of experimental autoimmune encephalomyelitis (EAE) mice. Deficiency of P2Y12 led to a reduced peak severity and cumulative disease score in EAE mice, followed by a dramatic reduction of leukocyte infiltration and less extensive demyelination...
May 17, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28513618/age-increases-monocyte-adhesion-on-collagen
#6
Samira Khalaji, Lisa Zondler, Fenneke KleinJan, Ulla Nolte, Medhanie A Mulaw, Karin M Danzer, Jochen H Weishaupt, Kay-E Gottschalk
Adhesion of monocytes to micro-injuries on arterial walls is an important early step in the occurrence and development of degenerative atherosclerotic lesions. At these injuries, collagen is exposed to the blood stream. We are interested whether age influences monocyte adhesion to collagen under flow, and hence influences the susceptibility to arteriosclerotic lesions. Therefore, we studied adhesion and rolling of human peripheral blood monocytes from old and young individuals on collagen type I coated surface under shear flow...
May 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28508148/thermographic-skin-temperature-measurement-compared-with-cold-sensation-in-predicting-the-efficacy-and-distribution-of-epidural-anesthesia
#7
Arnoud A Bruins, Kay R J Kistemaker, Annemieke Boom, John H G M Klaessens, Rudolf M Verdaasdonk, Christa Boer
Due to the high rates of epidural failure (3-32%), novel techniques are required to objectively assess the successfulness of an epidural block. In this study we therefore investigated whether thermographic temperature measurements have a higher predictive value for a successful epidural block when compared to the cold sensation test as gold standard. Epidural anesthesia was induced in 61 patients undergoing elective abdominal, thoracic or orthopedic surgery. A thermographic picture was recorded at 5, 10 and 15 min following epidural anesthesia induction...
May 15, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28507805/generation-and-functional-characterization-of-mdsc-like-cells
#8
Annkristin Heine, Stefanie Andrea Erika Held, Jonas Schulte-Schrepping, Julia Friederike Andrea Wolff, Kathrin Klee, Thomas Ulas, Niklas Arndt Schmacke, Solveig Nora Daecke, Kati Riethausen, Joachim L Schultze, Peter Brossart
Myeloid-derived suppressor cells (MDSC) are critical in regulating immune responses by suppressing antigen presenting cells (APC) and T cells. We previously observed that incubation of peripheral blood monocytes with interleukin (IL)-10 during their differentiation to monocyte-derived dendritic cells (moDCs) results in the generation of an APC population with a CD14(+)HLA-DR(low)phenotype (IL-10-APC) with reduced stimulatory capacity similar to human MDSC. Co-incubation experiments now revealed that the addition of IL-10-APC to moDC caused a reduction of DC-induced T-cell proliferation, of the expression of maturation markers, and of secreted cytokines and chemokines such as TNF-α, IL-6, MIP-1α and Rantes...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/28507026/lineage-specific-metabolic-properties-and-vulnerabilities-of-t-cells-in-the-demyelinating-central-nervous-system
#9
Scott M Seki, Max Stevenson, Abagail M Rosen, Sanja Arandjelovic, Lelisa Gemta, Timothy N J Bullock, Alban Gaultier
Multiple sclerosis (MS) is a disease that is characterized by immune-mediated destruction of CNS myelin. Current MS therapies aim to block peripheral immune cells from entering the CNS. Although these treatments limit new inflammatory activity in the CNS, no treatment effectively prevents long-term disease progression and disability accumulation in MS patients. One explanation for this paradox is that current therapies are ineffective at targeting immune responses already present in the CNS. To this end, we sought to understand the metabolic properties of T cells that mediate ongoing inflammation in the demyelinating CNS...
May 15, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#10
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28503906/more-than-words-the-role-of-multiword-sequences-in-language-learning-and-use
#11
Morten H Christiansen, Inbal Arnon
The ability to convey our thoughts using an infinite number of linguistic expressions is one of the hallmarks of human language. Understanding the nature of the psychological mechanisms and representations that give rise to this unique productivity is a fundamental goal for the cognitive sciences. A long-standing hypothesis is that single words and rules form the basic building blocks of linguistic productivity, with multiword sequences being treated as units only in peripheral cases such as idioms. The new millennium, however, has seen a shift toward construing multiword linguistic units not as linguistic rarities, but as important building blocks for language acquisition and processing...
May 14, 2017: Topics in Cognitive Science
https://www.readbyqxmd.com/read/28501796/nitric-oxide-synthase-inhibition-restores-orthostatic-tolerance-in-young-vasovagal-syncope-patients
#12
Julian M Stewart, Richard Sutton, Mira L Kothari, Amanda M Goetz, Paul Visintainer, Marvin Scott Medow
OBJECTIVE: Syncope is sudden transient loss of consciousness and postural tone with spontaneous recovery; the most common form is vasovagal syncope(VVS). We previously demonstrated impaired post-synaptic adrenergic responsiveness in young VVS patientswas reversed by blocking nitric oxide synthase(NOS). We hypothesised that nitric oxide may account for reduced orthostatic tolerance in young recurrent VVS patients. METHODS: We recorded haemodynamics in supine VVS and healthy volunteers (aged 15-27 years), challenged with graded lower body negative pressure (LBNP) (-15, -30, -45 mm Hg each for 5 min, then -60 mm Hg for a maximum of 50 min) with and without NOS inhibitor N(G)-monomethyl-L-arginine acetate(L-NMMA)...
May 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28501410/effects-of-dietary-energy-allowance-and-decline-in-dry-matter-intake-during-the-dry-period-on-responses-to-glucose-and-insulin-in-transition-dairy-cows
#13
S Salin, A Vanhatalo, K Elo, J Taponen, R C Boston, T Kokkonen
We assessed whether high energy intake during the early dry period [144% of metabolizable energy (ME) requirements/d] followed by a gradual restriction of energy intake in the close-up dry period (119% of ME/d; HEI) impaired whole-body insulin sensitivity compared with a controlled energy intake (100% of ME/d; CEI) throughout the 6-wk dry period. Multiparous Ayrshire dairy cows (n = 16) were blocked by body weight, body condition score, and expected date of parturition and were used in a randomized complete block design until 10 d after parturition...
May 10, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28499583/histotype-tailored-neoadjuvant-chemotherapy-versus-standard-chemotherapy-in-patients-with-high-risk-soft-tissue-sarcomas-isg-sts-1001-an-international-open-label-randomised-controlled-phase-3-multicentre-trial
#14
Alessandro Gronchi, Stefano Ferrari, Vittorio Quagliuolo, Javier Martin Broto, Antonio Lopez Pousa, Giovanni Grignani, Umberto Basso, Jean-Yves Blay, Oscar Tendero, Robert Diaz Beveridge, Virginia Ferraresi, Iwona Lugowska, Domenico Franco Merlo, Valeria Fontana, Emanuela Marchesi, Davide Maria Donati, Elena Palassini, Emanuela Palmerini, Rita De Sanctis, Carlo Morosi, Silvia Stacchiotti, Silvia Bagué, Jean Michelle Coindre, Angelo Paolo Dei Tos, Piero Picci, Paolo Bruzzi, Paolo Giovanni Casali
BACKGROUND: Previous trials from our group suggested an overall survival benefit with five cycles of adjuvant full-dose epirubicin plus ifosfamide in localised high-risk soft-tissue sarcoma of the extremities or trunk wall, and no difference in overall survival benefit between three cycles versus five cycles of the same neoadjuvant regimen. We aimed to show the superiority of the neoadjuvant administration of histotype-tailored regimen to standard chemotherapy. METHODS: For this international, open-label, randomised, controlled, phase 3, multicentre trial, patients were enrolled from 32 hospitals in Italy, Spain, France, and Poland...
May 9, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28497931/is-outpatient-continuous-regional-analgesia-more-effective-and-equally-safe-than-single-shot-peripheral-nerve-blocks-after-ambulatory-orthopedic-surgery-a-systematic-review-of-randomized-double-blinded-placebo-controlled-trials
#15
Andrea Saporito, Luciano Anselmi, Evelina Sturini, Alain Borgeat, José A Aguirre
BACKGROUND: Continuous regional analgesia is an established technique for effective postoperative pain treatment, particularly after orthopedic surgical procedures. Even if it has been increasingly applied to the outpatient setting as well, many anesthesiologists are still reluctant to discharge patients with a perineural catheter in place. Aim of this review was to clarify the evidences about safety and effectiveness of outpatient continuous peripheral nerve blocks. METHODS: A systematic review of all prospective, randomized, double-blinded, placebo-controlled trials of the last 20 years on outpatient continuous peripheral nerve blocks after ambulatory orthopedic surgery was performed, using both PubMed and OVID databases were...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28496416/lysophosphatidic-acid-is-associated-with-atherosclerotic-plaque-instability-by-regulating-nf-%C3%AE%C2%BAb-dependent-matrix-metalloproteinase-9-expression-via-lpa2-in-macrophages
#16
Chun Gu, Fang Wang, Zhenwen Zhao, Hongyue Wang, Xiangfeng Cong, Xi Chen
Lysophosphatidic acid (LPA), one of the simplest phospholipid signaling molecules, participates in formation and disruption of atherosclerotic plaque. Matrix metalloproteinases (MMPs) contribute to atherosclerotic plaque rupture by involving in extracellular matrix (ECM) degradation and then thinning fibrous cap. Our previous study demonstrated that macrophage-derived MMP-9 was associated with coronary plaque instability, but the relationship between LPA and MMP-9 remains unclear. The present work therefore aimed at elucidating association between LPA and MMP-9 and the regulation mechanism of LPA on MMP-9 in macrophages...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28494764/possible-benefits-of-tomato-juice-consumption-a-pilot-study-on-irradiated-human-lymphocytes-from-healthy-donors
#17
Ayumi Nakamura, Chieko Itaki, Ayako Saito, Toko Yonezawa, Koichi Aizawa, Ayumi Hirai, Hiroyuki Suganuma, Tomisato Miura, Yasushi Mariya, Siamak Haghdoost
BACKGROUND: Reactive oxygen species (ROS) mediate much of the DNA damage caused by ionizing radiation. Among carotenoids, lycopene and β-carotene, present in tomato juice, are known to be strong radical scavengers. The aim of the study was to investigate the effect of tomato juice intake on the levels of DNA damage and oxidative stress in human whole blood induced by in vitro exposure to X-rays. METHODS: Ten healthy adults were asked to drink 190 g of tomato juice, containing 17 mg lycopene and 0...
May 12, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28494560/-visual-impact-of-sub-tenon-s-anesthesia-during-surgery-for-retinal-detachment
#18
W Q Chen, G H Zhang, H J Lin, H C Huang, D S Lin, J L Zheng, D Z Zheng
Objective: To investigate the visual impact and influence factors of sub-Tenon's anesthesia in retinal detachment patients during pars plana vitrectomy (PPV) or combined phacoemulsification and PPV surgery. Methods: In this prospective case series study, 104 consecutive patients who underwent PPV or combined phacoemulsification and PPV under sub-Tenon's anesthesia between October 2012 and December 2013 were enrolled. Intraoperatively, the patients were asked whether they could see the light of the operating microscope or not at 5 minutes after sub-Tenon's anesthesia, and at the end of phacoemulsification, core vitreous removal, peripheral vitreous removal and the whole surgery, with their contralateral eyes being covered tightly and no photobleaching...
May 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28494088/peripheral-nerve-blocks-for-hip-fractures
#19
REVIEW
Joanne Guay, Martyn J Parker, Richard Griffiths, Sandra Kopp
BACKGROUND: Various nerve blocks with local anaesthetic agents have been used to reduce pain after hip fracture and subsequent surgery. This review was published originally in 1999 and was updated in 2001, 2002, 2009 and 2017. OBJECTIVES: This review focuses on the use of peripheral nerves blocks as preoperative analgesia, as postoperative analgesia or as a supplement to general anaesthesia for hip fracture surgery. We undertook the update to look for new studies and to update the methods to reflect Cochrane standards...
May 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28490900/complex-management-of-a-patient-with-refractory-primary-erythromelalgia-lacking-a-scn9a-mutation
#20
Sarah A Low, Wendye Robbins, Vivianne L Tawfik
A 41-year-old woman presented with burning and erythema in her extremities triggered by warmth and activity, which was relieved by applying ice. Extensive workup was consistent with adult-onset primary erythromelalgia (EM). Several pharmacological treatments were tried including local anesthetics, capsaicin, ziconotide, and dantrolene, all providing 24-48 hours of relief followed by symptom flare. Interventional therapies, including peripheral and sympathetic ganglion blocks, also failed. Thus far, clonidine and ketamine have been the only effective agents for our patient...
2017: Journal of Pain Research
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