Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2005
Propofol dose-dependently reduces tumor necrosis factor-alpha-Induced human umbilical vein endothelial cell apoptosis: effects on Bcl-2 and Bax expression and nitric oxide generation.
We investigated whether propofol can inhibit tumor necrosis factor (TNF)-alpha-induced apoptosis in cultured human umbilical vein endothelial cells (HUVECs). Isolated HUVECs were cultured in Dulbecco's modified Eagle medium supplemented with 20% bovine calf serum. HUVECs in untreated and propofol control groups were cultured at 37 degrees C for 24.5 h. ⋯ This was accompanied by increases in nitric oxide production. There is an inverse correlation between the ratio of Bcl-2/Bax expression and AI (P = 0.0009). These results suggest that propofol, at clinical relevant concentrations, can reduce TNF-induced HUVEC apoptosis.
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Pain physicians in Ohio come from many medical backgrounds and use different medical boards to claim board certification in the field of pain medicine. Our goal was to explore the number, demographics, and qualifications of pain physicians in Ohio. The names of Ohio physicians designating themselves as pain physicians were collected from the State Medical Board of Ohio and the American Medical Association. ⋯ Ninety-six (29%) of the Ohio pain physicians were certified in pain medicine by the American Board of Anesthesiology, the American Board of Physical Medicine and Rehabilitation, or the American Board of Psychiatry and Neurology, which are all member boards of the ABMS. One-hundred-seventeen (35%) of the self-declared Ohio pain physicians held no pain-related board certification. Anesthesiologists comprise the majority of all pain physicians and are the majority in all four pain boards.
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Anesthesia and analgesia · Jun 2005
Oxygen consumption with mechanical ventilation in a field anesthesia machine.
Field anesthesia machines (FAM) with gas-powered ventilators have been developed for remote locations that may not have a central supply of oxygen. These ventilators may rapidly deplete oxygen cylinders, especially in patients with decreased pulmonary compliance. Our goal in this study was to determine oxygen consumption rates with a contemporary FAM in models of high (HC) and low (LC) pulmonary compliance. ⋯ Oxygen consumption varied directly with Vt and inversely with compliance, increasing from 4.8 +/- 0.07 L/min with the HC-500 mL Vt model to 6.2 +/- 0.05 L/min with the LC-1000 mL Vt model. D cylinder duration ranged from 56.8 +/- 0.4 to 73.6 +/- 1.0 minutes. Assuming oxygen fresh gas flow of 1 L/min, calculating tank duration with the fastest consumption rate underestimated the tank duration for more compliant and smaller Vt models but provided a greater margin of patient safety.
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Anesthesia and analgesia · Jun 2005
Molecular properties important for inhaled anesthetic action on human 5-HT3A receptors.
Although inhaled anesthetics have diverse effects on 5-hydroxytryptamine type 3 (5-HT3A) receptors, the mechanism accounting for this diversity is not understood. Studies have shown that modulation of 5-HT3A receptor currents by n-alcohols depends on molecular volume, suggesting that steric interactions between n-alcohols and their binding sites define their action on this receptor. Electrostatic interactions also play an important role in anesthetic action on other ligand-gated receptors. ⋯ However, only agents smaller than 0.120 nm3 shifted the 5-HT3A receptor's serotonin concentration-response curve to the left, whereas larger anesthetics shifted them to the right. Modulation of human 5-HT3A-mediated currents by volatile anesthetics exhibits a dependence on molecular volume consistent with the n-alcohols, suggesting that both classes of agents may enhance 5-HT3A receptor function via the same mechanism. Furthermore, the enhancing but not inhibiting effects of anesthetic compounds on 5-HT3A receptor currents are modulated by electrostatic interactions.