International journal of clinical and experimental medicine
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In the pediatric hematology-oncology population, lumbar punctures (LP's) are commonly performed to administer intrathecal chemotherapy and obtain CSF samples. Difficult LP's can arise due to obesity, fibrous tissue formation due to repeated LP procedures, or spinal abnormalities. For difficult LP's that require imaging-guidance, fluoroscopy is generally?? Fluoroscopy, however, subjects the patient and healthcare providers to radiation while also potentially increasing procedure cost and time. ⋯ Our preliminary data suggests that ultrasound may be an efficacious alternative to fluoroscopy. By using ultrasound to identify the landmarks in the lumbar region, the appropriate puncture point can be determined allowing access to the intrathecal space with relative ease. This would decrease the need for fluoroscopy-guidance, the incidence of multiple punctures as well as reducing the procedure time and costs.
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There is some disagreement about whether the PetCO2 is reliable in predicting the PaCO2 in laparoscopic procedures with CO2 inflation. The aim of the present study is to measure the Pa-etCO2 differences over time in healthy patients undergoing gynecological laparoscopic surgery with different ventilation methods. ⋯ Oxygen concentration and positive end-expiratory pressure could affect Pa-etCO2 in laparoscopic surgery patients.
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Several studies documented persistent hypothermia in parturients after spinal anesthesia, while others reported that labor analgesia was related to a high incidence of fever. Continuous spinal labor anesthesia with sufentanil (CSLAS) is a new effective technique in labor analgesia but whether it affects maternal temperature has not been clarified. The aim of our study was to explore the relationship between CSLAS and maternal intrapartum temperature during vaginal delivery. ⋯ The technique of continuous sufentanil spinal labor anesthesia is a safe and effective method in labor analgesia; however, it is associated with an increased incidence of maternal fever.
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To determine the level of brain-derived neurotrophic factor (BDNF) in experimental dog model of severe acute cauda equina syndrome, which was induced by multiple cauda equina constrictions throughout the entire lumbar (L), sacral (S) and coccygeal (Co) spinal cord and their central processes of the dorsal root ganglia neurons. Adult male mongrel dogs were randomly divided into 2 groups. The experiment group (n=4) was subjected to multiple cauda equina constrictions. ⋯ Level of BDNF in the spinal cord and the dorsal root ganglion cells (L7, S1-S3) was assessed 48 hours after multiple constrictions by immunohistochemical and histopathological analyses. 48 hours after multiple constrictions of cauda equina, up-regulation of BDNF within lumbosacral (L7-S3) spinal cord and dorsal root ganglion was observed in experimental group as compared to control group. Our result suggests that BDNF might play a role in the inflammatory and neuropathic pain as a result of multiple cauda equina constrictions. Regulation of BDNF level could potentially provide a therapy for treating cauda equina syndrome.
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Burn and toll-like receptors (TLR) are associated with innate immune system activation, but the impact of burn on TLR-induced inflammation responses by circulating leukocytes is unknown. To study this, C57BL/6 mice were subjected to burn (3(rd) degree, 25% TBSA) or sham procedure and 1-7 days later blood was collected. ⋯ TLR2-induced KC and MIP-1β production was greater in the burn group at 3-7 days post-injury, whereas IL-6, IL-10, KC and MIP-1β were greater for TLR4-induced activation after burn. In conclusion, circulating leukocytes were responsive to TLR-induced activation and TLR-mediated inflammatory responses were enhanced 3-7 days post-injury, as evidenced by increased production of these inflammatory mediators.