Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2010
Ketamine inhibits transcription factors activator protein 1 and nuclear factor-kappaB, interleukin-8 production, as well as CD11b and CD16 expression: studies in human leukocytes and leukocytic cell lines.
Recent data indicate that ketamine exerts antiinflammatory actions. However, little is known about the signaling mechanisms involved in ketamine-induced immune modulation. In this study, we investigated the effects of ketamine on lipopolysaccharide-induced activation of transcription factors activator protein 1 (AP-1) and nuclear factor-kappaB (NF-kappaB) in human leukocyte-like cell lines and in human blood neutrophils. ⋯ The immunoinhibitory effects of ketamine are at least in part caused by inhibition of transcription factors NF-kappaB and AP-1, which regulate production of proinflammatory mediators. However, signaling mechanisms different from those present in the central nervous system are responsible for ketamine-mediated immunomodulation.
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The use of imaging techniques in women who are pregnant has increased greatly over the past decade. This focused review discusses the risks and indications of ultrasonography, magnetic resonance imaging, computed tomographic scanning, and fluoroscopy for the evaluation of the parturient with non-obstetric disorders. Diagnostic imaging of the pregnant woman for the evaluation of disorders not related to pregnancy is evolving, and protocols will vary from institution to institution. The potential benefit from indicated diagnostic radiological procedures in the parturient nearly always outweighs risk to the fetus because radiation exposure from a single procedure conveys little fetal risk.