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https://www.readbyqxmd.com/read/29781504/epidural-versus-non-epidural-or-no-analgesia-for-pain-management-in-labour
#1
REVIEW
Millicent Anim-Somuah, Rebecca Md Smyth, Allan M Cyna, Anna Cuthbert
BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epidural or no pain relief during labour...
May 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29771387/functional-brown-adipose-tissue-and-sympathetic-activity-after-cold-exposure-in-humans-with-type-1-narcolepsy
#2
Lotte Hahn Enevoldsen, Marie Tindborg, Nichlas Lindegaard Hovmand, Christina Christoffersen, Helga Ellingsgaard, Charlotte Suetta, Bente Merete Stallknecht, Poul Joergen Jennum, Andreas Kjær, Steen Gammeltoft
Study objectives: To investigate the activity of brown adipose tissue (BAT) in type 1 narcolepsy patients during cold exposure using two separate scans of sympathetic and metabolic activity of BAT in order to evaluate whether orexin deficiency leads to altered non-shivering thermoregulation in narcolepsy. Methods: Seven patients with type 1 narcolepsy and seven healthy controls underwent two consecutive scans after 2 h cold exposure: 123I-meta-iodo-benzyl-guanidine (123I-MIBG) single photon emission computed tomography and 18F-2-deoxy-glucose (18F-FDG) positron emission tomography and computed tomography to visualize sympathetic innervation and metabolic activity of BAT, respectively...
May 15, 2018: Sleep
https://www.readbyqxmd.com/read/29770778/apolipoprotein-e-in-diet-induced-obesity-a-paradigm-shift-from-conventional-perception
#3
Kyriakos E Kypreos, Eleni A Karavia, Caterina Constantinou, Aikaterini Hatziri, Christina Kalogeropoulou, Eva Xepapadaki, Evangelia Zvintzou
Apolipoprotein E (APOE) is a major protein component of peripheral and brain lipoprotein transport systems. APOE in peripheral circulation does not cross blood brain barrier or blood cerebrospinal fluid barrier. As a result, peripheral APOE expression does not affect brain APOE levels and vice versa. Numerous epidemiological studies suggest a key role of peripherally expressed APOE in the development and progression of coronary heart disease while brain APOE has been associated with dementia and Alzheimer's disease...
November 1, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/29762083/independent-risk-factors-for-the-shivering-occurrence-during-induction-period-in-out-of-hospital-cardiac-arrest-survivors-treated-with-targeted-temperature-management
#4
Youn-Jung Kim, Jin Mi Park, Min Soo Kim, Seung Mok Ryoo, Young Soon Park, Sung Sook Kim, Yeo Ok Kim, Won Young Kim
The occurrence of shivering during the induction period of targeted temperature management (TTM) remains a therapeutic obstacle, which delays the achievement of target temperature. The aim of this study was to identify risk factors leading to shivering during the induction period. We analyzed a prospective cohort of adult out-of-hospital cardiac arrest (OHCA) survivors treated with TTM from January 2015 to June 2017. Patients who developed shivering during the induction period were compared to those who did not...
May 15, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29756066/postanaesthetic-shivering-from-pathophysiology-to-prevention
#5
REVIEW
Maria Bermudez Lopez
Postoperative shivering is a common complication of anaesthesia. Shivering is believed to increase oxygen consumption, increase the risk of hypoxemia, induce lactic acidosis, and catecholamine release. Therefore, it might increase the postoperative complications especially in high-risk patients. Moreover, shivering is one of the leading causes of discomfort for postsurgical patients. Shivering is usually triggered by hypothermia. However, it occurs even in normothermic patients during the perioperative period...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29739538/opioid-related-side-effects-postoperative-ileus-urinary-retention-nausea-and-vomiting-and-shivering-a-review-of-the-literature
#6
REVIEW
Hans Donald de Boer, Olivier Detriche, Patrice Forget
Opioids are widely used in clinical anesthesia. However, side effects include postoperative nausea and vomiting, shivering, ileus, and urine retention and are specifically discussed here. From the available evidence, it appears that the use of opioids is strongly associated with impaired gastrointestinal motility. Therefore, to prevent postoperative ileus, the use of opioids should be minimized and opioids should be replaced by other drugs. With regard to the risk of postoperative urinary retention, one problem is the lack of standardized definition...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29734360/physiological-responses-to-acute-cold-exposure-in-young-lean-men
#7
Francisco M Acosta, Borja Martinez-Tellez, Guillermo Sanchez-Delgado, Juan M A Alcantara, Pedro Acosta-Manzano, Antonio J Morales-Artacho, Jonatan R Ruiz
The aim of this study was to comprehensively describe the physiological responses to an acute bout of mild cold in young lean men (n = 11, age: 23 ± 2 years, body mass index: 23.1 ± 1.2 kg/m2) to better understand the underlying mechanisms of non-shivering thermogenesis and how it is regulated. Resting energy expenditure, substrate metabolism, skin temperature, thermal comfort perception, superficial muscle activity, hemodynamics of the forearm and abdominal regions, and heart rate variability were measured under warm conditions (22...
2018: PloS One
https://www.readbyqxmd.com/read/29732150/efficacy-of-prophylactic-epidural-ketamine-for-reducing-shivering-in-patients-undergoing-caesarean-section-with-combined-spinal-epidural-anesthesia
#8
Xing Xue, Ying Lv, Youhong Zhao, Yufang Leng, Yan Zhang
Intravenous ketamine is known to inhibit postoperative shivering; however, at present, there has been little research on whether this effect may be achieved with epidural application. The aim of the present study was to evaluate the efficacy and safety of epidural ketamine as a prophylactic agent to prevent shivering in patients undergoing caesarean section during combined spinal-epidural anesthesia. A prospective, randomized, double-blind study was performed. A total of 60 patients who were undergoing elective caesarean section under combined spinal-epidural anesthesia and had an American Society of Anesthesiologists physical status of I or II were recruited...
May 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29732033/comparison-of-preemptive-effect-of-intravenous-ketorolac-versus-meperidine-on-postoperative-shivering-and-pain-in-patients-undergoing-cesarean-section-under-spinal-anesthesia-a-prospective-randomized-double-blind-study
#9
Marzieh Beigom Khezri, Maryam Al-Sadat Mosallaei, Mehdi Ebtehaj, Navid Mohammadi
Background: Pain and shivering are two unpleasant problems in postoperative period. Various techniques are used to alleviate the postoperative shivering and pain. We compared the preemptive prescription of a single dose of intravenous meperidine and ketorolac on postoperative pain and shivering in patients undergoing cesarean section with spinal anesthesia. Methods: One hundred and fifty patients who were scheduled for elective cesarean section under spinal anesthesia were randomly allocated to one of three study groups to receive intravenous ketorolac (group K), meperidine (group M) or normal saline (group P)...
2018: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/29725775/in-vivo-detection-of-human-brown-adipose-tissue-during-cold-and-exercise-by-pet-ct
#10
Emmani B M Nascimento, Wouter D van Marken Lichtenbelt
The role of brown adipose tissue (BAT) in non-shivering thermogenesis is well established in animals. BAT is activated following cold exposure, resulting in non-shivering thermogenesis, to ensure a constant body temperature. In mitochondria of brown adipocytes, glucose and fatty acids are used as substrate for uncoupling resulting in heat production. Activated BAT functions as a sink for glucose and fatty acids and this hallmark has designated BAT a target in the fight against metabolic diseases like type 2 diabetes mellitus and obesity...
May 4, 2018: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/29696129/controlled-hypotension-during-rhinoplasty-a-comparison-of-dexmedetomidine-with-magnesium-sulfate
#11
Faranak Rokhtabnak, Soudabeh Djalali Motlagh, Mohamadreza Ghodraty, Alireza Pournajafian, Mojtaba Maleki Delarestaghi, Arash Tehrani Banihashemi, Zeinab Araghi
Objective: The current study aimed at comparing the efficacy of dexmedetomidine and magnesium sulfate to control blood pressure (BP) during rhinoplasty and the resultant effects on the quality of surgical field in terms of bleeding and visibility. Methods: The current randomized, prospective, double-blind study was conducted on 60 patients aged 18 to 50 years classified as ASA (American Society of Anesthesiologists) physical status I who were candidates for rhinoplasty...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29696107/comparing-the-effect-of-adding-fentanyl-sufentanil-and-placebo-with-intrathecal-bupivacaine-on-duration-of-analgesia-and-complications-of-spinal-anesthesia-in-patients-undergoing-cesarean-section
#12
Farnoush Farzi, Ali Mirmansouri, Bahram Naderi Nabi, Zahra Atrkar Roushan, Samaneh Ghazanfar Tehran, Mona Nematollahi Sani, Soodabe Makhlooghi Azad, Maryam Nemati
Background: Spinal anesthesia is the method of choice for most elective and emergency Cesarean sections. To increase the duration of anesthesia and improve the quality of analgesia during and after surgery, intrathecal opioids, as adjuvant drugs, are used in combination with local anesthetics. Methods: This was a double-blind clinical trial performed on 99 patients. Women were divided into 3 groups of fentanyl, sufentanil, and placebo. For fentanyl group, 12.5 mg of bupivacaine and 25 micrograms of fentanyl; for sufentanil group, 12...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29685019/effect-of-branched-chain-amino-acids-on-perioperative-temperature-glucose-level-and-fat-metabolism-in-patients-with-gastrointestinal-tumors
#13
L Y Wen, Y S Zhang, X Zhou, G Li, C Y Hu, Y Li, L J Jin
This study aimed to investigate the effect of branched chain amino acids (BCCAs) on perioperative temperature, glucose and fat metabolism in patients with gastrointestinal tumors. Fifty-six patients undergoing gastrointestinal tumor surgery were included in the study and randomly divided into two groups of 28 patients each: an experimental and a control group. During surgery, the experimental group received 5.64mL·Kg-1·h-1(4KJ·Kg-1·h-1) of BCCAs intravenously, through an infusion pump, and the control group received an equal volume of NaCl 0...
March 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29682865/efficacy-of-forced-air-warming-for-preventing-perioperative-hypothermia-and-related-complications-in-patients-undergoing-laparoscopic-surgery-a-randomized-controlled-trial
#14
Shu-Fen Su, Hsiao-Chi Nieh
BACKGROUND: Perioperatively, unexpected hypothermia may cause adverse surgical outcomes. However, few studies have explored the efficacy of forced-air warming in patients undergoing laparoscopic surgery. AIM/OBJECTIVE: To determine the efficacy of forced-air warming for preventing perioperative hypothermia and complications in patients undergoing laparoscopic surgery. METHODS: A total of 127 participants undergoing laparoscopic thoracic or abdominal surgery were recruited between January and November 2015...
April 23, 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29679742/adaptive-thermogenesis-by-dietary-n-3-polyunsaturated-fatty-acids-emerging-evidence-and-mechanisms
#15
REVIEW
Rong Fan, Karsten Koehler, Soonkyu Chung
Brown/beige fat plays a crucial role in maintaining energy homeostasis through non-shivering thermogenesis in response to cold temperature and excess nutrition (adaptive thermogenesis). Although numerous molecular and genetic regulators have been identified, relatively little information is available regarding thermogenic dietary molecules. Recently, a growing body of evidence suggests that high consumption of n-3 polyunsaturated fatty acids (PUFA) or activation of GPR120, a membrane receptor of n-3 PUFA, stimulate adaptive thermogenesis...
April 18, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29675580/brown-adipose-tissue-in-human-infants
#16
Martin E Lidell
Adapting to the cold extrauterine environment after birth is a great challenge for the newborn. Due to their high surface area-to-volume ratio, infants tend to lose more heat to the environment as compared to adults. In addition, human newborns lack sufficiently developed skeletal muscle mass to maintain body temperature through shivering thermogenesis, an important source of heat in cold-exposed adults. Evolution has provided humans and other placental mammals with brown adipose tissue (BAT), a tissue that converts chemically stored energy, in the form of fatty acids and glucose, into heat through non-shivering thermogenesis...
April 20, 2018: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/29628568/comparison-of-prophylactic-intravenous-magnesium-sulfate-with-tramadol-for-postspinal-shivering-in-elective-cesarean-section-a-placebo-controlled-randomized-double-blind-pilot-study
#17
Roopa Sachidananda, K Basavaraj, Safiya I Shaikh, G Umesh, Triveni Bhat, B Arpitha
Background and Aims: Cesarean sections are performed mostly under spinal anesthesia. Shivering is one of the distressing complications. The aim of the study was to compare the efficacy of intravenous (i.v) magnesium sulfate and tramadol with placebo (normal saline) on postspinal shivering in elective cesarean section when used as prophylaxis. Methods: One hundred and thirty-five pregnant women between 18 and 35 years age, belonging to the American Society of Anesthesiologists' physical Status II, undergoing elective cesarean section under spinal anesthesia were enrolled into the study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29593558/an-individualized-perception-based-protocol-to-investigate-human-physiological-responses-to-cooling
#18
Crystal L Coolbaugh, Emily C Bush, Elizabeth S Galenti, E Brian Welch, Theodore F Towse
Cold exposure, a known stimulant of the thermogenic effects of brown adipose tissue (BAT), is the most widely used method to study BAT physiology in adult humans. Recently, individualized cooling has been recommended to standardize the physiological cold stress applied across participants, but critical experimental details remain unclear. The purpose of this work was to develop a detailed methodology for an individualized, perception-based protocol to investigate human physiological responses to cooling. Participants were wrapped in two water-circulating blankets and fitted with skin temperature probes to estimate BAT activity and peripheral vasoconstriction...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29578831/is-it-feasible-and-safe-to-wake-cardiac-arrest-patients-receiving-mild-therapeutic-hypothermia-after-12-hours-to-enable-early-neuro-prognostication-the-therapeutic-hypothermia-and-early-waking-trial-protocol
#19
Noel Watson, Matt Potter, Grigoris Karamasis, Max Damian, Richard Pottinger, Gerald Clesham, Reto Gamma, Rajesh Aggarwal, Jeremy Sayer, Nicholas Robinson, Rohan Jagathesan, Alamgir Kabir, Kare Tang, Paul Kelly, Maria Maccaroni, Ramabhadran Kadayam, Raghu Nalgirkar, Gyanesh Namjoshi, Sali Urovi, Anirudda Pai, Kunal Waghmare, Vincenzo Caruso, James Hampton-Till, Marko Noc, John R Davies, Thomas R Keeble
Mild therapeutic hypothermia (MTH 33°C) post out-of-hospital cardiac arrest (OHCA) is widely accepted as standard of care. However, uncertainty remains around the dose and therapy duration. OHCA patients are usually kept sedated±paralyzed and ventilated for the first 24-36 hours, which allows for targeted temperature management, but makes neurological prognostication challenging. The aim of this study is to investigate the feasibility and safety of assessing the unconscious OHCA patient after 12 hours for early waking/extubation while continuing to provide MTH for 24 hours, and fever prevention for 72 hours by using an intravenous temperature management (IVTM) system and established conscious MTH anti-shiver regimens...
March 26, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29557378/neuroprotective-effect-of-bispectral-index-guided-fast-track-anesthesia-using-sevoflurane-combined-with-dexmedetomidine-for-intracranial-aneurysm-embolization
#20
Chao-Liang Tang, Juan Li, Zhe-Tao Zhang, Bo Zhao, Shu-Dong Wang, Hua-Ming Zhang, Si Shi, Yang Zhang, Zhong-Yuan Xia
Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1...
February 2018: Neural Regeneration Research
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