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https://www.readbyqxmd.com/read/28527718/rotenone-decreases-ischemia-induced-injury-by-inhibiting-mitochondrial-permeability-transition-in-mature-brains
#1
Evelina Rekuviene, Laima Ivanoviene, Vilmante Borutaite, Ramune Morkuniene
The mitochondrial permeability transition pore (mPTP) is thought to be implicated in brain ischemia-induced cell death. Here we sought to determine whether complex I (CI) of the mitochondrial electron transfer system may be involved in regulation of mPTP opening during ischemia and whether a specific inhibitor of this complex - rotenone can protect against ischemia-induced cell death in an experimental model of total ischemia in adult rat brains. Anesthetized Wistar rats were administered a single injection of rotenone (0...
May 17, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28526163/new-hypnotic-drug-development-and-pharmacologic-considerations-for-clinical-anesthesia
#2
REVIEW
Mariah Kincaid Tanious, Sascha S Beutler, Alan D Kaye, Richard D Urman
Since the public demonstration of ether as a novel, viable anesthetic for surgery in 1846, the field of anesthesia has continually sought the ideal anesthetic-rapid onset, potent sedation-hypnosis with a high therapeutic ratio of toxic dose to minimally effective dose, predictable clearance to inactive metabolites, and minimal side effects. This article aims to review current progress of novel induction agent development and provide an update on the most promising drugs poised to enter clinical practice. In addition, the authors describe trends in novel agent development, implications for health care costs, and implications for perioperative care...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526162/pharmacologic-considerations-of-anesthetic-agents-in-pediatric-patients-a-comprehensive-review
#3
REVIEW
Alan D Kaye, Charles J Fox, Ira W Padnos, Ken P Ehrhardt, James H Diaz, Elyse M Cornett, Debbie Chandler, Sudipta Sen, Shilpadevi Patil
Acute pain in the pediatric population has important differences in terms of biology, intrapopulation variation, and epidemiology. Discussion as to the pharmacologic considerations of anesthetic agents, such as induction agents, neuromuscular blockers, opioids, local anesthetics, and adjuvant agents, is presented in this article. Special considerations and concerns, such as risk for propofol infusion syndrome and adverse potential side effects of anesthesia agents, are discussed. Anesthesiologists managing pediatric patients need to have a firm understanding of physiologic and pharmacologic differences compared with the adult population...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526152/pharmacologic-properties-of-novel-local-anesthetic-agents-in-anesthesia-practice
#4
REVIEW
Chih H King, Sascha S Beutler, Alan D Kaye, Richard D Urman
Therapeutic duration of traditional local anesthetics when used in peripheral nerve blocks is normally limited. This article describes novel approaches to extend the duration of peripheral nerve blocks currently available or in development. Three newer approaches on extending the duration of peripheral nerve blocks include site-1 sodium channel blockers, novel local anesthetics delivery systems, and novel adjuvants of local anesthetics. Compared with plain amide-based and ester-based local anesthetics, alternative approaches show significant promise in decreasing postoperative pain, rescue opioid requirement, hospital length-of-stay, and overall health care cost, without compromising the established safety profile of traditional local anesthetics...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526151/novel-anticoagulant-agents-in-the-perioperative-setting
#5
REVIEW
Allyson Lemay, Alan D Kaye, Richard D Urman
An increasing number of oral anticoagulants have become available over the past decade. Each of these agents has differing implications on both regional and neuraxial anesthetic techniques. This article describes the pharmacology, pharmacokinetics, and pharmacodynamics of the most commonly used novel oral anticoagulants (NOACs). It also outlines recent guidelines for the use of NOACs in the perioperative setting, especially with regard to neuraxial anesthesia.
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526147/pharmacologic-considerations-of-anesthetic-agents-in-geriatric-patients
#6
REVIEW
Maunak V Rana, Lara K Bonasera, Gregory J Bordelon
Aging is a natural process of declining organ function and reserve. Census data show that the geriatric population is expected to grow to nearly 30%. More than half of geriatric patients have 1 or more surgical procedures in their lifetimes. Moreover, this is the population at greatest risk of morbidity and mortality with any given complication. There is remarkable variability in health across the age spectrum, from fit to frail and compromised. This variability requires a unique approach to anesthetic delivery and drug dosing on an individual basis to avoid complications such as postoperative cognitive dysfunction and delirium...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526146/perioperative-pharmacologic-considerations-in-obesity
#7
REVIEW
Simon Willis, Gregory J Bordelon, Maunak V Rana
Obesity has increased in incidence worldwide. Along with the increased number of obese patients, comorbid conditions are also more prevalent in this population. Obesity leads to changes in the physiology of patients along with an altered response to pharmacologic therapy. Vigilant perioperative physicians must be aware of the unique characteristics of administered agents in order to appropriately provide anesthetic care for obese patients. Because of the variability in tissue content in obese patients and changes in pharmacokinetic modeling, a one-size-fits-all approach is not justified and a more sophisticated and prudent approach is indicated...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526144/pulmonary-vasodilators-and-anesthesia-considerations
#8
REVIEW
Jeremy B Green, Brendon Hart, Elyse M Cornett, Alan D Kaye, Ali Salehi, Charles J Fox
Pulmonary hypertension (PH) is a complex disease process of the pulmonary vasculature system characterized by elevated pulmonary arterial pressures. Patients with PH are at increased risk for morbidity and mortality, including intraoperatively and postoperatively. Appreciation by the clinical anesthesiologist of the pathophysiology of PH is warranted. Careful and meticulous strategy using appropriate anesthetic medications, pulmonary vasodilator and inotropic agents, and careful fluid management all increase the likelihood of the best possible outcome in this challenging patient population...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526142/anticoagulant-reversal-and-anesthetic-considerations
#9
REVIEW
Joseph Meltzer, Joseph R Guenzer
Bleeding complications are a common concern with the use of anticoagulant agents. In many situations, reversing of neutralizing their effects may be warranted. Prothrombin complex concentrate replaces coagulation factors lowered by warfarin, as does fresh frozen plasma, but in a more concentrated form. Protamine negates the effect of heparin and combines chemically with heparin molecules to form an inactive salt. It also partially reverses the effects of low-molecular-weight heparin. Recombinant activated factor VII is a nonspecific procoagulant that activates the extrinsic clotting pathway, resulting in thrombin generation, but does not directly neutralize the activity of any of the new oral anticoagulants...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28523393/flavored-anesthetic-masks-for-inhalational-induction-in-children
#10
Aakriti Gupta, Preethy Joseph Mathew, Neerja Bhardwaj
OBJECTIVES: To evaluate the clinical efficacy of masking the odor of inhalational agents using fruit flavors on the anxiety behavior and compliance of children for inhalational induction. METHODS: A prospective randomized double blind, placebo controlled study was conducted on 60 unpremedicated children in the age group of 4-12 y. Thirty children received anesthetic masks smeared with a flavor of child's choice while the other 30 children were induced using masks without flavor...
May 19, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28521706/fibrinous-anterior-uveitis-and-recurrent-epithelial-erosion-following-topical-tetracaine-abuse
#11
Olga E Makri, Panagiotis Plotas, Foteini Tsapardoni, Ilias Georgalas, Constantinos D Georgakopoulos
A 54-year-old man presented complaining of severe pain and blurred vision in his left eye. Slit-lamp biomicroscopy revealed a large epithelial defect with an underlying prominent ring infiltrate and severe anterior uveitis with fibrinous exudates and hypopyon. Patient admitted abuse of topical tetracaine, which was discontinued and topical treatment with a non-steroidal anti-inflammatory agent, an antibiotic, a cycloplegic agent were instituted while a therapeutic contact lens was applied. Response to treatment was favorable with a rapid resolution of anterior uveitis within days while the epithelial defect fully healed within a month...
May 18, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28518083/bronchoalveolar-lavage-of-murine-lungs-to-analyze-inflammatory-cell-infiltration
#12
Lien Van Hoecke, Emma Richelle Job, Xavier Saelens, Kenny Roose
Bronchoalveolar Lavage (BAL) is an experimental procedure that is used to examine the cellular and acellular content of the lung lumen ex vivo to gain insight into an ongoing disease state. Here, a simple and efficient method is described to perform BAL on murine lungs without the need of special tools or equipment. BAL fluid is isolated by inserting a catheter in the trachea of terminally anesthetized mice, through which a saline solution is instilled into the bronchioles. The instilled fluid is gently retracted to maximize BAL fluid retrieval and to minimize shearing forces...
May 4, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28514021/an-update-systematic-review-of-fetal-death-congenital-anomalies-and-fertility-disorders-among-health-care-workers
#13
REVIEW
Charline Warembourg, Sylvaine Cordier, Ronan Garlantézec
BACKGROUND: Health care workers (HCWs) are occupationally exposed to various hazards, some associated with adverse pregnancy outcomes in previous reviews. This systematic review aims at synthesizing the recent literature on occupational exposures among HCWs related to fetal death, congenital anomalies, and fertility disorders. METHODS: We searched the Medline database from 2000 to 2015 for articles about all potential occupational exposures of women and men working in this sector...
June 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28512491/pulp-response-following-direct-pulp-capping-with-dentin-adhesives-and-mineral-trioxide-aggregate-an-animal-study
#14
Ali Akhavan, Farahnaz Arbabzadeh, Majid Bouzari, Sayed Mohammad Razavi, Amin Davoudi
INTRODUCTION: Pulp vitality and its continuous dentin prodution are essential for long-term success of direct pulp capping (DPC). The aim of present study was to evaluate the histopathological response of the canine pulp following DPC using either different dentin adhesive resins (DAR), calcium hydroxide (CH) or mineral trioxide aggregate (MTA). METHODS AND MATERIALS: DPC was done on 72 dog's teeth using 6 types of dental materials (n=12) (4 types of DAR, white MTA and CH)...
2017: Iranian Endodontic Journal
https://www.readbyqxmd.com/read/28509778/multiple-anesthetic-drug-sensitization-in-a-hairdresser-with-previous-immediate-type-hypersensitivity-to-penicillin-a-case-report
#15
Cristina Petrişor, Nadia Gherman, Manuela Sfichi, Marius Mureşan, Natalia Hagău
Risk factors for intraoperative immediate-type hypersensitivity reactions may require allergological evaluation. We report the case of a hairdresser with a positive history of penicillin hypersensitivity and anaphylactic shock during previous general anesthesia, whose in vivo and in vitro allergy tests were positive for neuromuscular blocking agents, opioids, and midazolam. Immediate-type hypersensitivity reactions to antibiotics and professional exposure to hairdressing products might induce simultaneous cross-sensitization to multiple drugs that are commonly used during general anesthesia...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28506542/coronary-sinus-isoflurane-concentration-in-cardiac-surgery
#16
Ka Ting Ng, R Peter Alston, George Just, Chris McKenzie
OBJECTIVE: Volatile anesthetic agents such as isoflurane may be associated with fewer adverse myocardial events compared with total intravenous anesthesia in cardiac surgery. The authors aimed to determine whether reasonable isoflurane concentrations at tissue level were being achieved to protect the myocardium using this agent. The isoflurane concentration in myocardium has never been measured. The primary aim was to sample coronary sinus (CS) blood and measure its isoflurane concentration...
March 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28494889/influence-of-the-perioperative-administration-of-magnesium-sulfate-on-the-total-dose-of-anesthetics-during-general-anesthesia-a-systematic-review-and-meta-analysis
#17
REVIEW
Laura Rodríguez-Rubio, Eduardo Nava, Julián Solís García Del Pozo, Joaquín Jordán
BACKGROUND: Magnesium sulfate displays numerous characteristics that make it a useful drug in anesthesiology (N-methyl-d-aspartate receptor antagonist, vasodilator, antiarrhythmic, inhibitor of catecholamine release and of acetylcholine in the terminal motor plate). The perioperative use of this drug as an adjuvant capable of decreasing the required dose of anesthetics, has been proposed. OBJECTIVES: To assess the influence of intravenous magnesium sulfate administration during general anesthesia on the overall dose of required anesthetics...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28494877/prevalence-of-malignant-hyperthermia-diagnosis-in-hospital-discharge-records-in-california-florida-new-york-and-wisconsin
#18
Zhen Lu, Henry Rosenberg, Guohua Li
STUDY OBJECTIVE: Malignant hyperthermia (MH) is a rare yet potentially fatal pharmacogenetic disorder triggered by exposure to inhalational anesthetics and the depolarizing neuromuscular blocking agent succinylcholine. Epidemiologic data on the geographic variation in MH prevalence is scant. The objective of this study is to examine the prevalence of recorded MH diagnosis in patients discharged from hospitals in four states in the United States. DESIGN: Observational study...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28490900/complex-management-of-a-patient-with-refractory-primary-erythromelalgia-lacking-a-scn9a-mutation
#19
Sarah A Low, Wendye Robbins, Vivianne L Tawfik
A 41-year-old woman presented with burning and erythema in her extremities triggered by warmth and activity, which was relieved by applying ice. Extensive workup was consistent with adult-onset primary erythromelalgia (EM). Several pharmacological treatments were tried including local anesthetics, capsaicin, ziconotide, and dantrolene, all providing 24-48 hours of relief followed by symptom flare. Interventional therapies, including peripheral and sympathetic ganglion blocks, also failed. Thus far, clonidine and ketamine have been the only effective agents for our patient...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28484490/intraluminal-administration-of-resiniferatoxin-protects-against-clostridium-difficile-toxin-a-induced-colitis
#20
Steven R Vigna
Clostridium difficile toxin A is a colonic inflammatory agent that acts partially by activation of TRPV1 (transient receptor potential vanilloid type 1). Resiniferatoxin (RTX) is an excitotoxin that activates TRPV1 at low concentrations and defunctionalizes TRPV1 at high concentrations. RTX at various doses was injected intraluminally into isolated ileal segments in anesthetized rats. After 3 hours, the treated segments were removed and inflammation was assessed. This acute treatment with RTX resulted in biphasic responses: (1) an increase in inflammation similar to that caused by toxin A and capsaicin at low doses of up to 100 ng RTX and (2) no inflammatory effect of RTX at higher doses (1-100 μg), consistent with a defunctionalizing or neurotoxic effect of RTX at high doses...
2017: Gastroenterology Research and Practice
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