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https://www.readbyqxmd.com/read/28625441/the-protective-effects-of-dexmedetomidine-on-ischemic-brain-injury-a-meta-analysis
#1
REVIEW
Lianxiang Jiang, Meizhu Hu, Yan Lu, Ya Cao, Yan Chang, Zeping Dai
BACKGROUND: Intracranial lesions, trauma or surgery-related damage activate immune inflammation and neuroendocrine responses, causing ischemic brain injury. Studies have shown that inflammatory cascade mediated by neuroendocrine hormones and proinflammatory mediators is implicated in the pathophysiology of ischemic brain injury. Alpha2-adrenoceptor agonists, dexmedetomidine, is widely used as neuroprotectants in anesthesia practice. However, it is still lack of a comprehensive meta-analysis to evaluate the neuroprotection of dexmedetomidine against ischemic brain injury via suppressing these two physiological responses...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28623178/adrenal-derived-stress-hormones-modulate-ozone-induced-lung-injury-and-inflammation
#2
Andres Henriquez, John House, Desinia B Miller, Samantha J Snow, Anna Fisher, Hongzu Ren, Mette C Schladweiler, Allen D Ledbetter, Fred Wright, Urmila P Kodavanti
Ozone-induced systemic effects are modulated through activation of the neuro-hormonal stress response pathway. Adrenal demedullation (DEMED) or bilateral total adrenalectomy (ADREX) inhibits systemic and pulmonary effects of acute ozone exposure. To understand the influence of adrenal-derived stress hormones in mediating ozone-induced lung injury/inflammation, we assessed global gene expression (mRNA sequencing) and selected proteins in lung tissues from male Wistar-Kyoto rats that underwent DEMED, ADREX, or sham surgery (SHAM) prior to their exposure to air or ozone (1ppm), 4h/day for 1 or 2days...
June 13, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28492016/vaginal-rejuvenation-using-energy-based-devices
#3
REVIEW
Cheryl Karcher, Neil Sadick
Physiologic changes in a woman's life, such as childbirth, weight fluctuations, and hormonal changes due to aging and menopause, may alter the laxity of the vaginal canal, damage the pelvic floor, and devitalize the mucosal tone of the vaginal wall. These events often lead to the development of genitourinary conditions such as stress urinary incontinence; vaginal atrophy; dryness; and physiologic distress affecting a woman's quality of life, self-confidence, and sexuality. Various treatment modalities are currently available to manage these indications, varying from invasive vaginal surgery to more benign treatments like topical vaginal hormonal gels or hormone-replacement therapy...
September 2016: International Journal of Women's Dermatology
https://www.readbyqxmd.com/read/28490347/gh-secreting-pituitary-macroadenoma-acromegaly-associated-with-progressive-dental-malocclusion-and-refractory-cpap-treatment
#4
Jaume Miranda-Rius, Lluís Brunet-LLobet, Eduard Lahor-Soler, David de Dios-Miranda, Josep Anton Giménez-Rubio
BACKGROUND: A link between progressive dental malocclusion, the use of a continuous positive airway pressure mask and GH-secreting pituitary macroadenoma (acromegaly) has not been previously reported. The present clinicopathological analysis stresses that tooth malposition should not be seen exclusively as a local process. CASE PRESENTATION: A 62-year-old caucasian man with no relevant medical history reported difficulty chewing food and perceived voice alteration during his annual periodontal check-up...
May 10, 2017: Head & Face Medicine
https://www.readbyqxmd.com/read/28469454/perioperative-management-of-thyroid-dysfunction
#5
REVIEW
Marcia Rashelle Palace
Due to the manifold effects of thyroid hormone across virtually all organ systems, the complications associated with thyroid dysfunction are numerous and diverse. The stresses encountered during the perioperative period may exacerbate underlying thyroid disorders, potentially precipitating decompensation and even death. Thus, it is of the utmost importance for the clinician to comprehend the mechanisms by which thyroid disease may complicate surgery and postoperative recovery and to be cognizant of the most effective means of optimizing the status of thyrotoxic and hypothyroid patients perioperatively...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28403322/serum-concentrations-of-brain-derived-neurotrophic-factor-in-patients-diagnosed-with-gender-dysphoria-undergoing-sex-reassignment-surgery
#6
Maiko A Schneider, Tahiana Andreazza, Anna Martha V Fontanari, Angelo B Costa, Dhiordan C da Silva, Bianca W de Aguiar, Raffael Massuda, Mariana Pedrini, Clarissa S Gama, Karine Schwarz, Marcia Kauer-Sant'Anna, Maria Ines R Lobato
Introduction: Transsexualism (ICD-10) is a condition characterized by a strong and persistent dissociation with one's assigned gender. Sex reassignment surgery (SRS) and hormone therapy provide a means of allowing transsexual individuals to feel more congruent with their gender and have played a major role in treatment over the past 70 years. Brain-derived neurotrophic factor (BDNF) appears to play a key role in recovery from acute surgical trauma and environmentally mediated vulnerability to psychopathology...
January 2017: Trends in Psychiatry and Psychotherapy
https://www.readbyqxmd.com/read/28383434/low-pressure-capnoperitoneum-reduces-stress-responses-during-pediatric-laparoscopic-high-ligation-of-indirect-inguinal-hernia-sac-a-randomized-controlled-study
#7
RANDOMIZED CONTROLLED TRIAL
Xiaoguang Niu, Xubin Song, Aiping Su, Shanshan Zhao, Qinghao Li
BACKGROUND: We aimed to evaluate the effect of different capnoperitoneum pressures on stress responses in pediatric laparoscopic inguinal hernia repair. METHODS: In this prospective randomized controlled study, 68 children with indirect inguinal hernia who underwent high ligation of hernia sac were randomly divided into 3 groups: high-pressure group (12 mm Hg, HP group, n = 26); low-pressure group (8 mm Hg, LP group, n = 20); open operation group (OP group, n = 22)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28346770/a-core-outcome-set-for-localised-prostate-cancer-effectiveness-trials
#8
Steven MacLennan, Paula R Williamson, Hanneke Bekema, Marion Campbell, Craig Ramsay, James N'Dow, Sara MacLennan, Luke Vale, Philipp Dahm, Nicolas Mottet, Thomas Lam
OBJECTIVE: To develop a core outcome set (COS) applicable for effectiveness trials of all interventions for localised prostate cancer. Many treatments exist for localised prostate cancer, although it is unclear which offers the optimal therapeutic ratio; which is confounded by inconsistencies in the selection, definition, measurement and reporting of outcomes in clinical trials. PATIENTS, SUBJECTS AND METHODS: A list of 79 outcomes was derived from a systematic review of published localised prostate cancer effectiveness studies and semi-structured interviews with 15 patients with prostate cancer patients...
March 27, 2017: BJU International
https://www.readbyqxmd.com/read/28290971/delayed-diagnosis-of-tsh-secreting-adenoma-attributed-to-worsening-post-traumatic-stress-disorder-symptoms-in-a-military-veteran-because-of-provider-anchoring-bias
#9
Shyam K Daya, Andrew O Paulus, Ernest E Braxton, Penny J Vroman, Derek A Mathis, Ryan Lin, Mark W True
INTRODUCTION: Anchoring bias occurs when clinicians hold on to previously known information about a patient, with failure to consider the full realm of possibilities to explain new findings. We present a case of delayed diagnosis of thyroid-stimulating-hormone-secreting pituitary adenoma (TSHoma), a rare disorder, in a military veteran whose symptoms were misconstrued as being caused from worsening of his prior diagnosis of post-traumatic stress disorder (PTSD). Anchoring bias in this case led to 2-year delay in the correct diagnosis...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28246105/insulin-resistance-and-normal-thyroid-hormone-levels-prospective-study-and-metabolomic-analysis
#10
Ele Ferrannini, Giorgio Iervasi, Jeff Cobb, Rudina Ndreu, Monica Nannipieri
While hyper/hypothyroidism causes dysglycemia, the relationship between thyroid hormone levels within the normal range and insulin resistance (IR) is unclear. In 940 participants with strictly normal serum concentrations of free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH)) followed up for 3 years, we measured insulin sensitivity (by the insulin clamp technique) and a panel of 35 circulating metabolites. At baseline, across quartiles of increasing fT3 levels (or fT3/fT4 ratio) there emerged most features of IR (male sex, higher BMI, waist circumference, heart rate, blood pressure, fatty liver index, free fatty acids, and triglycerides levels, reduced insulin-mediated glucose disposal and ß-cell glucose sensitivity)...
February 28, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28198198/comparative-evaluation-of-pain-stress-neuropeptide-y-acth-and-cortisol-levels-between-a-conventional-postoperative-care-protocol-and-a-fast-track-recovery-program-in-patients-undergoing-major-abdominal-surgery
#11
COMPARATIVE STUDY
Maria Kapritsou, Elizabeth D Papathanassoglou, Evangelos Bozas, Dimitrios P Korkolis, Evangelos A Konstantinou, Ioannis Kaklamanos, Margarita Giannakopoulou
BACKGROUND: Fast-track (FT) postoperative protocol in oncological patients after major abdominal surgery reduces complications and length of postoperative stay compared to the conventional (CON) protocol. However, stress and pain responses have not been compared between the two protocols. OBJECTIVES: To compare stress, pain, and related neuropeptidic responses (adrenocorticotropic hormone [ACTH], cortisol, and neuropeptide Y [NPY]) between FT and CON protocols. METHOD: A clinical trial with repeated measurements was conducted (May 2012 to May 2014) with a sample of 63 hepatectomized or pancreatectomized patients randomized into two groups: FT ( n = 29) or CON ( n = 34)...
March 2017: Biological Research for Nursing
https://www.readbyqxmd.com/read/28169489/psychological-and-endocrine-factors-and-pain-after-mastectomy
#12
D Nishimura, S Kosugi, Y Onishi, N Ihara, K Wakaizumi, H Nagata, T Yamada, T Suzuki, S Hashiguchi, H Morisaki
BACKGROUND: This prospective study was designed to examine the associations of demographic, clinical, psychological and neuroendocrine factors with acute and chronic post-operative pain following partial mastectomy. METHODS: Sixty-four female patients scheduled for partial mastectomy were enrolled. Pre-operative anxiety/depression was assessed, using the Hospital Anxiety and Depression Scale (HADS). Pre-operative 24-h urinary cortisol levels were measured 2 days before surgery...
February 7, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28118414/copeptin-predicts-mortality-in-critically-ill-patients
#13
Konstantin A Krychtiuk, Maria C Honeder, Max Lenz, Gerald Maurer, Johann Wojta, Gottfried Heinz, Kurt Huber, Walter S Speidl
BACKGROUND: Critically ill patients admitted to a medical intensive care unit exhibit a high mortality rate irrespective of the cause of admission. Besides its role in fluid and electrolyte balance, vasopressin has been described as a stress hormone. Copeptin, the C-terminal portion of provasopressin mirrors vasopressin levels and has been described as a reliable biomarker for the individual's stress level and was associated with outcome in various disease entities. The aim of this study was to analyze whether circulating levels of copeptin at ICU admission are associated with 30-day mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28073036/does-preoperative-oral-carbohydrate-treatment-reduce-the-postoperative-surgical-stress-response-in-lumbar-disc-surgery
#14
RANDOMIZED CONTROLLED TRIAL
Ozlem Korkmaz Dilmen, Ercument Yentur, Yusuf Tunali, Huriye Balci, Mois Bahar
OBJECTIVES: Surgical trauma produces metabolic and hormonal responses, which are characterized by insulin resistance. Due to extension of the preoperative fasting period, which increases the magnitude of postoperative insulin resistance, preoperative oral carbohydrates (POC) have been developed. PATIENTS AND METHODS: This prospective, randomized, controlled study was performed on 43 ASA I-II patients undergoing elective microsurgical lumbar discectomy. The intervention group received oral carbohydrate solution 800mL the night before and 400mL 2h prior to operation...
February 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28067075/perioperative-humoral-stress-response-to-laparoscopic-versus-open-aortobifemoral-bypass-surgery
#15
RANDOMIZED CONTROLLED TRIAL
Anne H Krog, Per M Thorsby, Mehdi Sahba, Erik M Pettersen, Irene Sandven, Jørgen J Jørgensen, Jon O Sundhagen, Syed S H Kazmi
Minimally invasive surgery seems to reduce hormonal stress response to surgery, but has not previously been examined in major abdominal vascular surgery. Aortic cross-clamping time and operation time is known to be longer in the totally laparoscopic aortobifemoral bypass (LABF) as compared to open aortobifemoral bypass (OABF). The main objective of our study was to measure the hormonal stress response during surgery and aortic cross-clamping in patients undergoing a totally laparoscopic versus an open aortobifemoral bypass...
April 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28042237/gut-microbiome-surgical-complications-and-probiotics
#16
REVIEW
George Stavrou, Katerina Kotzampassi
The trigger for infectious complications in patients following major abdominal operations is classically attributed to endogenous enteral bacterial translocation, due to the critical condition of the gut. Today, extensive gut microbiome analysis has enabled us to understand that almost all "evidence-based" surgical or medical intervention (antibiotics, bowel preparation, opioids, deprivation of nutrition), in addition to stress-released hormones, could affect the relative abundance and diversity of the enteral microbiome, allowing harmful bacteria to proliferate in the place of depressed beneficial species...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28008373/clinical-factors-disease-parameters-and-molecular-therapies-affecting-osseointegration-of-orthopedic-implants
#17
Hilal Maradit Kremers, Eric A Lewallen, Andre J van Wijnen, David G Lewallen
Total hip and knee arthroplasty are effective interventions for management of end-stage arthritis. Indeed, about 7 million Americans are currently living with artificial hip and knee joints. The majority of these individuals, however, will outlive their implants and require revision surgeries, mostly due to poor implant osseointegration and aseptic loosening. Revisions are potentially avoidable with better management of patient-related risk factors that affect the osseointegration of orthopedic implants. In this review, we summarize the published clinical literature on the role of demographics, biologic factors, comorbidities, medications and aseptic loosening risk...
September 2016: Current Molecular Biology Reports
https://www.readbyqxmd.com/read/27903577/adrenal-cushing-syndrome-with-detectable-acth-from-an-unexpected-source
#18
Thinzar M Lwin, Nehal Galal, Shweta Gera, Jennifer L Marti
Mixed corticomedullary adrenal tumours (MCMT) are rare. We describe the second reported case of a male patient presenting with hypertension and Cushing syndrome with MCMT. A man aged 48 years presented with hypertension and signs of Cushing syndrome. 24-hour urine cortisol was elevated, with detectable adrenocorticotropic hormone (ACTH). A high-dose dexamethasone suppression test indicated an adrenal or ectopic Cushing syndrome. Plasma metanephrines were normal. A 3 cm left adrenal mass was identified without potential ectopic sources of ACTH on imaging...
November 30, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27821836/effects-of-combined-general-epidural-anesthesia-on-hemodynamics-respiratory-function-and-stress-hormone-levels-in-patients-with-ovarian-neoplasm-undergoing-laparoscopy
#19
Qiang Xu, Hao Zhang, Yan-Mei Zhu, Nian-Jun Shi
BACKGROUND The aim of this study was to evaluate the influence of combined general/epidural anesthesia (GEA) on hemodynamics, respiratory function and stress hormone levels in patients with ovarian neoplasm undergoing laparoscopy. MATERIAL AND METHODS A total of 177 patients with ovarian neoplasm (screened by inclusion/exclusion criteria) receiving laparoscopy were divided into groups G (general anesthesia alone), L1.0 (GEA with 1.0% lidocaine), and L1.5 (GEA with 1.5% lidocaine). Hemodynamics, respiratory parameters and stress hormone levels in the 3 groups were recorded and analyzed...
November 8, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27776761/intraoperative-low-frequency-electroacupuncture-under-general-anesthesia-improves-postoperative-recovery-in-a-randomized-trial
#20
RANDOMIZED CONTROLLED TRIAL
Dennis Grech, Zhifeng Li, Patrick Morcillo, Evelyne Kalyoussef, David D Kim, Alex Bekker, Luis Ulloa
Neuronal stimulation improves physiological responses to infection and trauma, but the clinical potential of this strategy is unknown. We hypothesized that transdermal neural stimulation through low-frequency electroacupuncture might control the immune responses to surgical trauma and expedite the postoperative recovery. However, the efficiency of electroacupuncture is questioned due to the placebo effect. Here, electroacupuncture was performed on anesthetized patients to avoid any placebo. This is a prospective double-blinded pilot trial to determine whether intraoperative electroacupuncture on anesthetized patients improves postoperative recovery...
October 2016: Journal of Acupuncture and Meridian Studies
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