The Journal of surgical research
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Adding neuraxial to general anesthesia (GA) has been associated with improved perioperative outcome after orthopedic surgery. Presuming a similar effect in major abdominal surgery we studied its effect on perioperative outcome in open colectomy patients. ⋯ We found no clear pattern of consistent favorable results for patients undergoing their open colectomy under GNA. Further prospective research is needed to help identify those who are more likely to benefit from GNA use and its mechanism of actions.
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Penetrating cardiac injuries carry a significant mortality, especially if operative intervention is delayed because of diagnostic difficulties. ⋯ Penetrating cardiac injuries are highly lethal. A high index of suspicion, coupled with early operative intervention remains the key in securing the survival of these patients.
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Both aspirin therapy and trauma impair platelet function. Platelet dysfunction is associated with worse outcomes in patients with traumatic intracranial hemorrhage (ICH). Platelet transfusion is often used to limit progression of ICH in patients on aspirin, but has not been shown to improve platelet function or outcomes. We hypothesized that platelet transfusion would improve aspirin-induced, but not trauma-induced, platelet dysfunction. ⋯ Patients with isolated ICH have trauma-induced platelet dysfunction. In addition, patients on aspirin have drug-induced abnormalities in platelet response to AA. Platelet transfusion improves aspirin-induced, but not trauma-induced, platelet dysfunction.
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Sepsis-induced cardiomyopathy (SIC) is thought to be the result of detrimental effects of inflammatory mediators on the cardiac muscle. Here we studied the effects of prolonged (24 ± 4 h) exposure of adult rat ventricular myocytes (ARVM) to bacterial lipopolysaccharide (LPS) and inflammatory cytokines tumor necrosis factor (TNF) and interleukins-1 (IL-1) and IL-6. ⋯ Prolonged exposure of ARVM to a mixture of LPS and inflammatory cytokines inhibits cell contractility. The effect is mediated by the inhibition of Ca(2+) influx via LTCC, and partially opposed by the inhibition of Na(+)/Ca(2+) exchange. Because both mechanisms are commonly seen in animal models of SIC, we conclude that prolonged challenge with Cytomix-100 of ARVM may represent an accurate in vitro model for SIC.
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Comparative Study
Effects of ischemic preconditioning protocols on skeletal muscle ischemia-reperfusion injury.
Ischemic preconditioning (IPC) is described as brief ischemia-reperfusion (I/R) cycles to induce tolerance to subsequent in response to longer I/R insults. Various IPC protocols can be performed in four combinations as follows: at early or late phases and on local or distant organs. Although many experimental studies have been performed on IPC, no consensus has been established on which IPC protocol is most effective. The aims of the present study were as follows: (1) to compare the variables of preconditioning in different combinations (in early versus late phases; local versus remote organ implementations) and (2) to determine the most therapeutic IPC protocol(s). ⋯ All IPC protocols were effective in reducing I/R injury. Among these protocols, e-RIPC achieved most protection.