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The secrets of anesthesia

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
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...
September 21, 2016: Ophthalmology
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
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
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
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...
September 11, 2016: Journal of Veterinary Medical Science
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
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
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
Tao Jiang, Li-fa Huang, Shui-jing Zhou, Jian-jun Cui, Qiang Ye
OBJECTIVE: To observe cerebral protective effect of muscone (nasal administration) on traumatic brain injury model rats. METHODS: SD rats were divided into the sham-operation group, the model group, and the treatment groups according to random digit table, 50 in each group. Traumatic brain injury model was established by controlled cortical strike. Rats in the sham-operation group received surgery and anesthesia procedures only, with no strike. Muscone (1.8 mg/kg) was delivered to rats in the treatment group using in situ nasal perfusion, 30 min each time, twice daily for 7 successive days...
June 2016: Chinese Journal of Integrated Traditional and Western Medicine
Koji Koizumi, Toru Fujioka, Toshiaki Yasuoka, Aya Inoue, Yuka Uchikura, Hiroki Tanaka, Katsuko Takagi, Miki Mori, Masae Koizumi, Hisashi Hashimoto, Takashi Matsumoto, Yuko Matsubara, Keiichi Matsubara, Akihiro Nawa
Multiple techniques have been used for the conservative treatment of high-grade cervical intraepithelial neoplasia (HG-CIN) in women of fertile age. Conization has been associated with stenosis of the cervix and a decrease in cervical mucus secretion, in addition to the increase in the risk of cervical canal shortening and problems during the perinatal period, including premature birth and premature rupture of membranes. Although the laser transpiration technique does not cause shortening of the cervical canal, it is associated with the recurrent risk of deep residual disease...
August 2016: Molecular and Clinical Oncology
Karl-M Schebesch, Elisabeth Bründl, Petra Schödel, Andreas Hochreiter, Judith Scheitzach, Sylvia Bele, Alexander Brawanski, Eva-M Störr, Anette Lohmeier, Martin Proescholdt
BACKGROUND: Neuropeptide Y (NPY) is one of the most potent endogenous vasoconstrictors, and its contribution to the multifactorial cascade of cerebral vasospasm due to nontraumatic subarachnoid hemorrhage (SAH) is not yet fully understood. This experimental study compared the hemorrhage-specific course of NPY secretion into cerebrospinal fluid (CSF) and into plasma between 2 groups: patients with SAH and patients with basal ganglia hemorrhage (BGH) or cerebellar hemorrhage (CH) over the first 10 days after hemorrhage...
July 19, 2016: Journal of Neurosurgical Anesthesiology
Guanghai Liu, Tiangui Zhu, Aihua Zhang, Feng Li, Weidong Qian, Bin Qian
OBJECTIVE: Children with repeated exposures to anesthesia at an early age are at an increased risk of cognitive impairment. Data in the literature link increased developmental depolarizing γ-aminobutyric acid (GABA) type A receptor (GABAAR) at younger age to neurodevelopmental disorders. Here we investigated the involvement of GABAergic signaling during development in mediating the adverse effects of repeated sevoflurane exposures. METHODS: Sprague-Dawley male rats received repeated exposures to 3 % sevoflurane for 2 h daily for 3 consecutive days on postnatal days (P) 4, 5, and 6; maternally separated and unseparated rats served as controls...
October 2016: Journal of Anesthesia
Lizbeth Carrillo, Héctor Sumano, Luis Medina-Torres, Graciela Tapia, Lilia Gutiérrez
The rheological properties of pooled tracheobronchial secretions (TBS) of chicken, including mucus, have not been characterized. Yet mucolytic drugs are frequently used in poultry medicine. To define such properties, TBS from healthy untreated and from chickens treated with various mucolytic drugs was studied. Three hundred, three-week-old Rhode Island Red chickens were divided into five groups, with three repetitions each (n = 20) as follows: ambroxol (GAmb), ethylene diamine dihydro-iodide (GEddi), carbocysteine (GCs), bromhexine (GBr), and an untreated control group (CG)...
July 14, 2016: Poultry Science
Matthew W Dyer, Amy Gnagey, Bryan T Jones, Roger D Pula, William L Lanier, John L D Atkinson, Jeffrey J Pasternak
BACKGROUND: Thyroid-stimulating hormone (TSH)-secreting pituitary adenomas are a rare cause of secondary hyperthyroidism. Anesthetic management of these patients has not been formally described in the literature. MATERIALS AND METHODS: Patients who underwent resection of a TSH-secreting pituitary adenoma during 1987 to 2012 at a single institution were identified. Preoperative thyroid hormone state, anesthetic management, and outcome were recorded. Hemodynamic associations with intraoperative events were compared between those who were hyperthyroid and euthyroid at the time of surgery...
June 17, 2016: Journal of Neurosurgical Anesthesiology
Katsuya Tanaka, Yasuo M Tsutsumi
It is important for the anesthesiologists to understand pathophysiology of perioperative stress hyperglycemia, because it offers strategies for treatment of stress hyperglycemia. The effect of glucose tolerance is different in the choice of the anesthetic agent used in daily clinical setting. Specifically, the volatile anesthetics inhibit insulin secretion after glucose load and affects glucose tolerance. During minor surgery by the remifentanil anesthesia, the stress reaction is hard to be induced, suggesting that we should consider low-dose glucose load...
May 2016: Masui. the Japanese Journal of Anesthesiology
Ayman Ads, Frederic Auerbach, Kelly Ryan, Abdel R El-Ganzouri
We report the successful use of the Air-Q laryngeal airway (Air-Q LA) as a ventilatory device and a conduit for tracheal intubation to rescue the airway in a patient with difficult airway and tracheal stenosis. This is the first case report of the device to secure the airway after two episodes of hypoxemia in the operating room and intensive care unit. Consent for submission of this case report was obtained from our institution's human studies institutional review board given that the patient died a few months after his discharge from the hospital before his personal consent could be obtained and before preparation of this report...
August 2016: Journal of Clinical Anesthesia
J Kyle Bohman, Rahul Kashyap, Augustine Lee, Zhaoping He, Sam Soundar, Laura L Bolling, Daryl J Kor
INTRODUCTION: Patients at risk for microaspiration during elective intubation often receive cricoid pressure in the hopes of mitigating such risk. However, there is scarce evidence to either support or reject this practice. The objective of this investigation was to assess the effect of cricoid pressure on microaspiration and to inform the potential feasibility of conducting a larger, more definitive clinical trial. METHODS: This was a pilot randomized clinical trial set in the operating rooms of a tertiary referral hospital between August and October of 2014...
June 7, 2016: Clinical Respiratory Journal
Johanne A Windeløv, Jens Pedersen, Jens J Holst
Evaluation of the impact of anesthesia on oral glucose tolerance in mice. Anesthesia is often used when performing OGTT in mice to avoid the stress of gavage and blood sampling, although anesthesia may influence gastrointestinal motility, blood glucose, and plasma insulin dynamics. C57Bl/6 mice were anesthetized using the following commonly used regimens: (1) hypnorm/midazolam repetitive or single injection; (2) ketamine/xylazine; (3) isoflurane; (4) pentobarbital; and (5) A saline injected, nonanesthetized group...
June 2016: Physiological Reports
Saeedeh Darzi, Jerome A Werkmeister, James A Deane, Caroline E Gargett
UNLABELLED: SummaryHuman endometrium is a highly regenerative tissue, undergoing more than 400 cycles of proliferation, differentiation, and shedding during a woman's reproductive life. Adult stem cells, including mesenchymal stem/stromal cells (MSCs), are likely responsible for the immense cellular turnover in human endometrium. The unique properties of MSCs, including high proliferative ability, self-renewal, differentiation to mesodermal lineages, secretion of angiogenic factors, and many other growth-promoting factors make them useful candidates for cellular therapy and tissue engineering...
September 2016: Stem Cells Translational Medicine
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