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The secrets of anesthesia

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https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#1
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28193459/epileptiform-activity-and-behavioral-arrests-in-mice-overexpressing-the-calcium-channel-subunit-%C3%AE-2%C3%AE-1
#2
Leonardo C Faria, Feng Gu, Isabel Parada, Ben Barres, Z David Luo, David A Prince
: The alpha2delta-1 subunit (α2δ-1) of voltage-gated calcium channels is a receptor for astrocyte-secreted thrombospondins that promote developmental synaptogenesis.Alpha2delta-1 receptors are upregulated in models of injury-induced peripheral pain and epileptogenic neocortical trauma associated with an enhancement of excitatory synaptic connectivity. These results lead to the hypothesis that overexpression of α2δ-1 alone in neocortex of uninjured transgenic (TG) mice might result in increased excitatory connectivity and consequent cortical hyperexcitability and epileptiform activity...
February 10, 2017: Neurobiology of Disease
https://www.readbyqxmd.com/read/28183569/gastric-regurgitation-in-patients-undergoing-gynecological-laparoscopy-with-a-laryngeal-mask-airway-a-prospective-observational-study
#3
Jeconias Lemos, Gildasio S De Oliveira, Hugo Eckner Dantas de Pereira Cardoso, Lavínia Dantas Cardoso Neiva Lemos, Lígia Raquel de Carvalho, Norma Suely Pinheiro Módolo
OBJECTIVE: The use of pneumoperitonium and the placement of patients in Trendelenburg position are commonly cited reasons for the potential development of intraoperative regurgitation of gastric contents and the need for an endotracheal tube in laparoscopic surgery. The main objective of the current investigation was to evaluate the presence of regurgitation of gastric contents in the oropharynx of patients having laparoscopic gynecological surgery with a laryngeal mask airway (LMA). DESIGN: Prospective, observational clinical investigation...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28117793/topical-airway-anesthesia-for-awake-endoscopic-intubation-using-the-spray-as-you-go-technique-with-high-oxygen-flow
#4
Nina Pirlich, Jana A Lohse, Rüdiger R Noppens
A patient's willingness to cooperate is an absolute precondition for successful awake intubation of the trachea. Whilst drug-sedation of patients can jeopardize their spontaneous breathing, topical anesthesia of the airway is a popular technique. The spray-as-you-go technique represents one of the simplest opportunities to anesthetize the airway mucosa. The application of local anesthetic through the working channel of the flexible endoscope is a widespread practice for anesthetists as well as pulmonologists...
January 13, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28102732/exacerbating-effects-of-pm2-5-in-ova-sensitized-and-challenged-mice-and-the-expression-of-trpa1-and-trpv1-protein-in-lung
#5
Hong Liu, Xinsheng Fan, Naiqian Wang, Yuyan Zhang, Jinghua Yu
OBJECTIVE: To investigate the effects of PM2.5 on asthma-related phenotypes and on the expression of TRPA1, V1 protein in lung in a mouse model of asthma. METHODS: Female Balb/c mice were utilized to establish 28 and 42 day asthma models. Mice were sensitized with OVA and challenged with OVA, OVA plus normal saline (NS), or OVA plus PM2.5 at two doses, 1.6 mg·kg(-1) or 8.0 mg·kg(-1). PM2.5 was administrated by intratracheal instillationwithout anesthesia. 24 hours after the final OVA challenge changes in airway resistance (RI) and lung compliance (Cdyn) in response to acetylcholine chloride (ACH) were evaluated, and blood, bronchoalveolar lavage fluid (BALF) and lung tissue samples were taken...
January 19, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28017828/effect-of-dezocine-on-il-12-and-il-10-secretion-and-lymphocyte-activation-by-culturing-dendritic-cells-from-human-umbilical-cord-blood
#6
Chang Feng, Man Feng, Ran Jiao, Dongyi Liu, Yanwu Jin, Xin Zhao, Ruixue Xiao
Dezocine has been generally utilized for pain therapy and auxiliary anesthesia. Although it has some advantages on the prevention of some anesthesia related complications, its effect on immune responses remains unclear. Our study investigated the effects of Dezocine on IL-10 and IL-12 secretion and lymphocytes activation by culturing dendritic cells (DCs), and revealed the underlying mechanism. Mononuclear cells were divided into negative control group (GN), positive control group (GP), experimental group (GD; GD5, D7, D9)...
December 22, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28005257/safety-of-transsphenoidal-microsurgical-approach-in-patients-with-an-acth-secreting-pituitary-adenoma
#7
Carmine Antonio Donofrio, Marco Losa, Marco Gemma, Lodoviga Giudice, Lina Raffaella Barzaghi, Pietro Mortini
PURPOSE: Patients affected by Cushing's disease often have important comorbidities directly linked to hypercortisolism that might enhance the operative risk. We report the safety of transsphenoidal surgery in patients affected by Cushing's disease as compared with patients with nonfunctioning pituitary adenoma. METHODS: We have retrospectively analyzed 142 patients with Cushing's disease and 299 patients with nonfunctioning pituitary adenoma who underwent transsphenoidal surgery performed by a single experienced neurosurgeon between September 2007 and December 2014...
December 22, 2016: Endocrine
https://www.readbyqxmd.com/read/27990829/-islet-transplantation-as-a-treatment-for-hypoglycemia-unawareness-syndrome-evaluation-of-the-pilot-program-and-comparison-with-pancreas-transplantation
#8
Martina Zahradnická, Peter Girman, Jan Kříž, Zuzana Berková, Tomáš Koblas, Ema Vávrová, Lucie Kosinová, David Habart, Eva Fábryová, Eva Dovolilová, Tomáš Neškudla, Jan Peregrin, Jozef Kováč, Květoslav Lipár, Matěj Kočík, Lenka Németová, Jiří Svoboda, František Saudek
Islet transplantation (ITx) started in 2005 in IKEM as a potentially safer alternative to pancreas transplantation (PTx), which so far had represented the method of choice in type-1 diabetic patients with conservatively intractable hypoglycemia unawareness syndrome. The aim of the study was to compare these two methods with regard to severe hypoglycemia elimination and to frequency of complications.Up to November 2015 a total number of 48 patients underwent ITx. The results from 22 patients with hypoglycemia unawareness were statistically analyzed...
2016: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#9
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27866310/prediction-of-difficult-laryngoscopy-using-spirometry-a-pilot-study
#10
Serkan Dogru, Tugba Karaman, Aynur Sahin, Hakan Tapar, Serkan Karaman, Semih Arici, Mustafa Suren, Ziya Kaya, Battal Tahsin Somuk
Prediction of difficult laryngoscopy is still the uncovered secret of anesthetic practice. This pilot study is aimed to assess the efficacy of spirometry measurements in predicting difficult laryngoscopy compared with conventional airway assessment techniques. We enrolled 202 adults, ages 18-40 years, with an American Society of Anaesthesiologists score of I or II, scheduled for elective surgery and undergoing general anesthesia. Spirometry was used for lung capacity measurements before the operation. The Mallampati classification, neck circumference, sternomental distance, thyromental distance, maximum mouth-opening measurement, and upper lip bite test of the subjects were measured...
November 19, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27830200/photorefractive-keratectomy-for-patients-with-preoperative-low-schirmer-test-value
#11
Elham Tanbakouee, Mohammad Ghoreishi, Mohammad Aghazadeh-Amiri, Mehdi Tabatabaee, Mohadeseh Mohammadinia
PURPOSE: To compare dry eye signs and symptoms between patients with preoperative low and normal Schirmer test after Photorefractive keratectomy (PRK). METHODS: In this prospective, nonrandomized, comparative case series, 76 eyes of 76 patients were preoperatively categorized into two groups according to selected criteria for characterization of tear film status: the low Schirmer test value (STV) group and the normal STV group. For the tear function assessment, we performed a Schirmer test with and without anesthesia, tear break-up time (TBUT) test, and measurement dry eye symptoms using the Farsi translation of Ocular Surface Disease Index (OSDI) questionnaire pre- and 3 months post-operation...
December 2016: Journal of Current Ophthalmology
https://www.readbyqxmd.com/read/27687340/anesthetic-management-of-a-myotonic-dystrophy-patient-with-paraganglionoma
#12
Ashwin Subramaniam, Robert Grauer, David Beilby, Ravindranath Tiruvoipati
Myotonic dystrophy (DM), though rare, can significantly complicate anesthesia due to muscular and extra-muscular involvement. When this condition is compounded by a pheochromocytoma, anesthetizing such patients becomes extra challenging. We present a case report of a 61-year-old lady with congenital DM, with the whole gamut of associated features, was diagnosed with a noradrenaline secreting paraganglionoma following investigation of refractory hypertension. We anesthetized her for an open resection of the lesion...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27665213/matrix-metalloproteinase-9-testing-in-dry-eye-disease-using-a-commercially-available-point-of-care-immunoassay
#13
Elisabeth M Messmer, Victoria von Lindenfels, Alexandra Garbe, Anselm Kampik
PURPOSE: To measure matrix metalloproteinase 9 (MMP-9) in the tear film of patients with dry eye disease (DED) compared with controls and to correlate clinical findings. DESIGN: In a prospective study, 101 patients and controls underwent MMP-9 testing of the tear film. Thereafter, they were evaluated for symptoms and signs of DED. PARTICIPANTS: Included patients were those who showed 3 of the following 4 dry eye criteria: ocular surface disease index (OSDI) score of more than 12, tear film break-up time (TBUT) of 10 seconds or less, Schirmer test results without anesthesia of less than 10 mm/5 minutes, and corneal staining results of 1 or more...
November 2016: Ophthalmology
https://www.readbyqxmd.com/read/27648689/hyperoxia-induces-inflammation-and-cytotoxicity-in-human-adult-cardiac-myocytes
#14
Christina Hafner, Jing Wu, Akos Tiboldi, Moritz Hess, Goran Mitulovic, Christoph Kaun, Konstantin Alexander Krychtiuk, Johann Wojta, Roman Ullrich, Eva Verena Tretter, Klaus Markstaller, Klaus Ulrich Klein
Supplemental oxygen (O2) is used as adjunct therapy in anesthesia, emergency and intensive care medicine. We hypothesized that excessive O2 levels (hyperoxia) can directly injure human adult cardiac myocytes (HACMs). HACMs obtained from the explanted hearts of transplantation patients were exposed to constant hyperoxia (95% O2), intermittent hyperoxia (alternating 10 min exposures to 5% and 95% O2), constant normoxia (21% O2), or constant mild hypoxia (5% O2) using a bioreactor. Changes in cell morphology, viability as assessed by lactate dehydrogenase (LDH) release and trypan blue (TB) staining, and secretion of vascular endothelial growth factor (VEGF), macrophage migration inhibitory factor (MIF), and various pro-inflammatory cytokines (interleukin, IL; chemokine C-X-C motif ligand, CXC; granulocyte-colony stimulating factor, G-CSF; intercellular adhesion molecule, ICAM; chemokine C-C motif ligand, CCL) were compared among treatment groups at baseline (0 h) and after 8 h, 24 h, and 72 h of treatment...
September 19, 2016: Shock
https://www.readbyqxmd.com/read/27642575/severe-respiratory-event-initially-thought-to-be-inadvertent-endobronchial-intubation-possible-complications-from-using-of-a-topical-metered-dose-of-8-lidocaine-pump-spray
#15
Young-Chang P Arai, Jun Kawanishi, Yoshikazu Sakakima, Koichi Ohmoto, Akihiro Ito, Yuki Maruyama, Tatsunori Ikemoto
INTRODUCTION: Pulmonary collapse after intubation is common, and it is caused by a variety of factors. CASE PRESENTATION: A 21-year-old man presented at our operation room to undergo an appendectomy. Except for a history of cigarette smoking, his history was negative. Anesthesia was induced with 100% oxygen and sevoflurane, remifentanil infusion, and propofol. Neuromuscular block was obtained with rocuronium. The tip and cuff of a tracheal tube were lubricated with a topical metered-dose of 8% Lidocaine pump spray...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27625606/activation-of-muscarinic-acetylcholine-receptor-subtype-4-is-essential-for-cholinergic-stimulation-of-gastric-acid-secretion-relation-to-d-cell-somatostatin
#16
Koji Takeuchi, Takuya Endoh, Shusaku Hayashi, Takeshi Aihara
BACKGROUND/AIM: Muscarinic acetylcholine receptors exist in five subtypes (M1∼M5), and they are widely expressed in various tissues to mediate diverse autonomic functions, including gastric secretion. In the present study, we demonstrated, using M1∼M5 KO mice, the importance of M4 receptors in carbachol (CCh) stimulation of acid secretion and investigated how the secretion is modulated by the activation of M4 receptors. METHODS: C57BL/6J mice of wild-type (WT) and M1-M5 KO were used...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27616555/a-case-of-acute-postoperative-transitory-sialadenosis-of-the-submandibular-glands-in-a-healthy-dog
#17
Andrea Cattai, Silvia Levorato, Paolo Franci
A 1-year-old healthy female cross-breed dog, weighing 4.5 kg, was scheduled for elective neutering. Fentanyl (5 µg/kg) and propofol (4 mg/kg) were administered intravenously (IV) to induce anesthesia, which was maintained with isoflurane and a constant fentanyl infusion rate (10 µg/kg/hr). During the recovery from the anesthesia, the presence of bilateral dense submandibular masses was recognized, as was the excessive secretion of saliva. An ultrasound examination was performed and revealed bilateral abnormally-diffused enlargement of the submandibular salivary glands...
January 10, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/27586279/on-the-natural-and-unnatural-history-of-the-voltage-gated-na-channel
#18
E G Moczydlowski
This review glances at the voltage-gated sodium (Na(+)) channel (NaV) from the skewed perspective of natural history and the history of ideas. Beginning with the earliest natural philosophers, the objective of biological science and physiology was to understand the basis of life and discover its intimate secrets. The idea that the living state of matter differs from inanimate matter by an incorporeal spirit or mystical force was central to vitalism, a doctrine based on ancient beliefs that persisted until the last century...
2016: Current Topics in Membranes
https://www.readbyqxmd.com/read/27529317/effect-of-intraoperative-glucose-infusion-on-catabolism-of-adipose-tissue-and-muscle-protein-in-patients-anesthetized-with-remifentanil-in-combination-with-sevoflurane-during-major-surgery-a-randomized-controlled-multicenter-trial
#19
Atsushi Sawada, Yasuhiro Kamada, Haruko Hayashi, Hiromichi Ichinose, Shinzo Sumita, Michiaki Yamakage
BACKGROUND: A harmful effect of stress hormone secretion during surgery is lipolysis and proteolysis to maintain normal blood glucose levels. A well-titrated general anesthetic improves blood glucose control by suppressing secretion of these stress hormones. The aim of this study was to explore the effect of intraoperative glucose infusion on lipolysis and proteolysis in patients undergoing a general anesthetic consisting of sevoflurane and remifentanil during long (>6 hours) major surgery...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27516654/anesthesia-and-pain-relief-in-the-history-of-islamic-medicine
#20
Faranak Alembizar, Ayda Hosseinkhani, Alireza Salehi
BACKGROUND: Since diseases and surgeries could be very painful, the annihilation of pain has been the most important goal of physicians. The history of Iranian-Islamic medicine includes distinguished physicians that attempted to find different methods of anesthesia. This research aims at reviewing approaches for anesthesia throughout the history of the Iranian-Islamic medicine, in order to identify a variety of drugs used during that period. METHODS: In this research, the information was mainly collected from medical history, traditional literature and various search engines (e...
May 2016: Iranian Journal of Medical Sciences
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