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Patrick C Even, Anne Blais
The components of energy expenditure, total metabolic rate (TMR), resting metabolic rate (RMR), thermogenic response to feeding (TEF), activity, and cost of activity were measured in fed and fasted mice housed at 22 and 30°C. Mice housed at 22°C had more than two times larger TMR and RMR. Mice at 22°C were less active when fasted but more active when fed. Cost of activity was nearly doubled in the fasted and in the fed state. Analysis of the short-term relation between TMR, RMR, and bouts of activity showed that, at 22°C, the bouts of activity induced a decrease in the intensity of RMR that reflected the reduced need for thermal regulation induced by the heat released from muscular contraction...
2016: Frontiers in Nutrition
Tonny Stone Luggya, Richard Nicholas Kabuye, Cephas Mijumbi, Joseph Bahe Tindimwebwa, Andrew Kintu
BACKGROUND: Surgery and anaesthesia cause shivering due to thermal dysregulation as a compensatory mechanism and is worsened by vasodilatation from spinal anaesthesia that redistributes core body heat. Due to paucity of data Mulago Hospital's post spinal shivering burden is unknown yet it causes discomfort and morbidity. METHODS: Ethical approval was obtained to perform the study among consenting mothers due for elective caesarean section from March to May 2011...
October 18, 2016: BMC Anesthesiology
Martin Jastroch, Sylvain Giroud, Perry Barrett, Fritz Geiser, Gerhard Heldmaier, Annika Herwig
Endothermic mammals and birds require intensive energy turnover to sustain high body temperatures and metabolic rates. To cope with energetic bottlenecks associated with the change of seasons, and to minimise energy expenditure, complex mechanisms and strategies, such as daily torpor and hibernation, are used. During torpor metabolic depression and low body temperatures save energy. However, these bouts of torpor lasting for hours to weeks are interrupted by active 'euthermic' phases with high body temperatures...
October 18, 2016: Journal of Neuroendocrinology
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
Mapi Fleury, Caroline Fonzo-Christe, Charline Normand, Pascal Bonnabry
A heavily immunosuppressed, 43-kg, 9-year-old patient was recovering from a bone marrow transplant. Primary prophylaxis against invasive fungal infections was liposomal amphotericin B (AmBisome(®), 2.3 mg/kg [100 mg] two times per week). Once home, following a first amphotericin B infusion, he presented with strong diarrhoea and vomiting; this was repeated after the second infusion. The clinical situation worsened rapidly and the patient was rehospitalised. On admission, he presented with acute renal failure...
December 2016: Drug Saf Case Rep
Kalpana Rajendra Kulkarni, Amruta Girish Naik, Sunetra Girish Deshpande
BACKGROUND: Spinal anesthesia is a preferred technique over general anesthesia for cesarean delivery. It avoids maternal airway related complications, aspiration and neonatal depression. However hypotension following spinal anesthesia can lead to decrease in uterine blood flow and neonatal hypoxia. AIMS: We aimed to evaluate the efficacy of 15 1of crystalloid preloading versus prophylactic intravenous bolus of 10 mg ephedrine as an antihypotensive measure for cesarean section...
September 2016: Anesthesia, Essays and Researches
Amit Agrawal, Veena Asthana, J P Sharma, Vineeta Gupta
BACKGROUND: Subarachnoid block is the preferred technique for providing anesthesia for patients undergoing cesarean section. Various pharmacological agents in added to local anesthetics (LA) modify their original effects in terms of block characteristics and quality of analgesia. However, there is ongoing debate about this practice of using adjuncts with LA. We tested whether addition of lipophilic versus lipophobic opioids to LA gives any clinical benefits to maternal and fetal outcome when used in these patients requiring spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
Richard R Reich, Cecile A Lengacher, Carissa B Alinat, Kevin E Kip, Carly Paterson, Sophia Ramesar, Heather S Han, Roohi Ismail-Khan, Versie Johnson-Mallard, Manolete Moscoso, Pinky Budhrani-Shani, Steve Shivers, Charles E Cox, Matthew Goodman, Jong Park
CONTEXT: Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biological and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters. OBJECTIVES: The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program...
October 5, 2016: Journal of Pain and Symptom Management
Xiangdi Yu, Fangxiang Zhang
BACKGROUND: Pain during cesarean delivery is one of the more common reasons for a successful medicolegal claim. However, creating an extensive block area can result in hypotension, so determining the precise dose of local anesthetic is critical. OBJECTIVES: Investigate effects of parturient height on the median effective dose (ED50) of intrathecally-administered ropivacaine. DESIGN: Prospective cross-sectional analytic study. SETTING: Anesthesiology department in a provinicial hospital in China...
September 2016: Annals of Saudi Medicine
Li Shuying, Li Ping, Lin Xuemei
BACKGROUND: Postoperative shivering (POS) is a common complication that occurs after regional and general anesthesia. Thus far, numerous studies have reported on the effectiveness of tramadol in preventing or treating POS. Here, we performed a meta-analysis to assess the efficacy of tramadol in the prevention of POS. METHODS: We systematically searched PubMed, Embase and the Cochrane Library to identify studies of the efficacy of tramadol in the prevention of POS...
October 5, 2016: Minerva Anestesiologica
Shoaleh Shami, Karim Nasseri, Mousa Shirmohammadi, Farzad Sarshivi, Negin Ghadami, Ebrahim Ghaderi, Mokhtar Pouladi, Arvin Barzanji
INTRODUCTION: Shivering is among the unpleasant and potentially harmful side effects of spinal anesthesia. The aim of this randomized double-blind clinical trial was to compare the antishivering effect of two different doses of intrathecal pethidine on the incidence and intensity of shivering and other side effects in patients who underwent cesarean section. METHODS: In this study, 150 parturient females scheduled for nonemergent cesarean section were randomly allocated to three groups...
2016: Drug Design, Development and Therapy
Ali Solhpour, Alireza Jafari, Masoud Hashemi, Behnam Hosseini, Sajad Razavi, Gholamreza Mohseni, Maryam Vosoughian, Faranak Behnaz, Reza Amin Nejad, Mohamad Amin Pourhoseingholi, Fereshteh Soltani
STUDY OBJECTIVES: The aim of this study is to compare the efficacy of combination of meperidine and dexamethasone with that of placebo, meperidine alone, and the combination of ketamine and midazolam in preventing shivering during spinal anesthesia. DESIGN: This is a prospective, placebo-controlled study. SETTING: The setting is at an operating room of a university-based teaching hospital. PATIENTS: Two hundred American Society of Anesthesiologists I and II patients undergoing orthopedic and urologic surgery under spinal anesthesia were included...
November 2016: Journal of Clinical Anesthesia
Joshua D Aaker, Benayahu Elbaz, Yuwen Wu, Timothy J Looney, Li Zhang, Bruce T Lahn, Brian Popko
The transcriptional program that controls oligodendrocyte maturation and central nervous system (CNS) myelination has not been fully characterized. In this study, we use high-throughput RNA sequencing to analyze how the loss of a key transcription factor, zinc finger protein 191 (ZFP191), results in oligodendrocyte development abnormalities and CNS hypomyelination. Using a previously described mutant mouse that is deficient in ZFP191 protein expression (Zfp191(null)), we demonstrate that key transcripts are reduced in the whole brain as well as within oligodendrocyte lineage cells cultured in vitro To determine whether the loss of myelin seen in Zfp191(null) mice contributes indirectly to these perturbations, we also examined the transcriptome of a well-characterized mouse model of hypomyelination, in which the myelin structural protein myelin basic protein (MBP) is deficient...
October 2016: ASN Neuro
Meghna Pant, Naresh C Bal, Muthu Periasamy
Skeletal muscle constitutes ∼40% of body mass and has the capacity to play a major role as thermogenic, metabolic, and endocrine organ. In addition to shivering, muscle also contributes to nonshivering thermogenesis via futile sarcoplasmic/endoplasmic reticulum Ca(2+) ATPase (SERCA) activity. Sarcolipin (SLN), a regulator of SERCA activity in muscle, plays an important role in regulating muscle thermogenesis and metabolism. Uncoupling of SERCA by SLN increases ATP hydrolysis and heat production, and contributes to temperature homeostasis...
September 13, 2016: Trends in Endocrinology and Metabolism: TEM
Mohammad Sadegh Sanie, Navid Kalani, Mohamed Amin Ghobadifar, Hassan Zabetian, Mehdi Hosseini
BACKGROUND: Postoperative shivering is a major problem in children undergoing general anesthesia. OBJECTIVES: The aim of the present study was to investigate the role of low-dose intravenous ketamine for prevention of shivering after induction of general anesthesia in children who had undergone tonsillectomy. PATIENTS AND METHODS: This was a randomized, double-blinded, placebo-controlled trial including 80 children, of American society of anesthesiologists (ASA) physical status I or II, scheduled for tonsillectomy under general anesthesia who were randomly assigned to an intravenous ketamine (0...
June 2016: Anesthesiology and Pain Medicine
Min Li, Xiaolan Hu, Yuan Tan, Baoping Yang, Kun Li, Zhenyu Tang
OBJECTIVES: Considerable controversy exists regarding the efficacy of ondansetron in preventing postanesthesia shivering (PAS). We performed a meta-analysis of randomized controlled trials to examine the controversy. MATERIALS AND METHODS: Randomized controlled trials assessing the effect of ondansetron on the prevention of PAS were identified from electronic databases (PubMed and EMBASE). The meta-analysis was performed with the fixed-effect model or random-effect model according to heterogeneity...
September 12, 2016: International Journal of Surgery
Tomasz Gaszynski
INTRODUCTION: We report on the anesthetic management using opioid-free method of a patient with Steinert syndrome (myotonic dystrophy, MD), autosomal dominant dystrophy which is characterized by consistent contracture of muscle following stimulation. A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. In patients with MD, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management...
September 2016: Medicine (Baltimore)
Wen Wang, Xiaojing Song, Tong Wang, Chaobin Zhang, Li Sun
The aim of this meta-analysis was to evaluate the preventive efficacy and safety of 5-HT3 receptor antagonists (5-HT3 RAs) on perioperative shivering. Relevant databases were searched to identify eligible randomized, controlled trials through January 2016. Primary outcome was the incidence of perioperative shivering, and secondary outcomes were the incidence of safety-related outcomes including postoperative nausea and vomiting (PONV), bradycardia, and hypotension. We calculated risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous data...
September 15, 2016: Journal of Clinical Pharmacology
Fidelis Anayo Onyekwulu, Edith Ebere Agu, Adaobi Obianuju Amucheazi
AIMS AND OBJECTIVES: The aim of this study was to evaluate the efficacy of intravenous tramadol in control of shivering in obstetric patients under spinal anaesthesia and to determine the minimal dose of tramadol that is effective. PATIENTS AND METHODS: This was a prospective, randomised, double-blind, cross-sectional study of 144 pregnant women at term who had an indication for caesarean section. The patients were randomly allocated into three groups at the occurrence of shivering...
July 2016: Nigerian Postgraduate Medical Journal
Ko-Eun Choi, Bomi Park, Asma M Moheet, Amanda Rosen, Shouri Lahiri, Axel Rosengart
Shivering is a common side effect of targeted temperature modulation and general anesthesia. Antishivering strategies often employ a stepwise approach involving both pharmacological and physical interventions. However, approaches to treat shivering are often empiric and vary widely across care environments. We evaluated the quality of published antishivering protocols and guidelines with respect to methodological rigor, reliability, and consistency of recommendations. Using 4 medical databases, we identified 4027 publications that addressed shivering therapy, and excluded 3354 due to lack of relevance...
September 12, 2016: Anesthesia and Analgesia
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