The Journal of surgical research
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Adrenomedullin (AM) is a recently discovered, potent vasodilatory peptide with activities including maintenance of cardiovascular and renal homeostasis. Studies have indicated that AM is important in initiating the hyperdynamic response during the early stage of sepsis, and reduction of the vascular effects of AM marks the transition from the initial hyperdynamic phase to the late hypodynamic phase in experimental sepsis. The decreased AM responsiveness in late sepsis may be related to alterations in the AM receptor binding characteristics and/or signaling pathways. ⋯ It appears that decreased levels of AMBP-1 play a critical role in producing vascular AM hyporesponsiveness during the late stage of sepsis. Furthermore, administration of AM and AMBP-1 in combination prevented the transition from the hyperdynamic to hypodynamic response during the progression of polymicrobial sepsis. Thus, modulation of vascular responsiveness to AM by AMBP-1 may provide a novel approach for the management of sepsis.
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Portions of the prospective, multi-institutional National Veterans Affairs Surgical Quality Improvement Program were used to develop and validate a perioperative risk index to predict abdominal wound dehiscence after laparotomy. ⋯ This abdominal wound dehiscence risk index identifies patients at risk for dehiscence and may be useful in guiding perioperative management.
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Insulin is proposed as a therapy for suppressing muscle wasting after burn trauma although the long-term effects of this therapy on wound healing are not yet known. The present study was designed to investigate the effect of systemically administered insulin therapy on burn wound healing. ⋯ These results indicate that insulin induces accelerated wound healing associated with diminished inflammation and increased collagen deposition.