bluuebunny/crossref_metadata_2025_split huggingface dataset:
Propofol Attenuates the Myocardial Protection Properties of Desflurane by Modulating Mitochondrial Permeability Transition
Authors: Heiberg Johan , Royse Colin F. , Royse Alistair G. , Andrews David T. 
Published: June 2018

BACKGROUND:
Desflurane and propofol are cardioprotective, but relative efficacy is unclear. The aim was to compare myocardial protection of single, simultaneous, and serial administration of desflurane and propofol.

METHODS:
Sixty New Zealand White rabbits and 65 isolated Sprague Dawley rat hearts randomly received desflurane, propofol, simultaneous desflurane and propofol, or sequential desflurane then propofol. Rabbits were subdivided to receive either ischemia-reperfusion with temporary occlusion of the left anterior descending artery or a time-matched, nonischemic perfusion protocol, whereas rat hearts were perfused in a Langendorff model with global ischemia-reperfusion. End points were hemodynamic, functional recovery, and mitochondrial uptake of 3H-2-deoxy-d-glucose as an indicator of mitochondrial permeability transition.

RESULTS:
In rabbits, there were minimal increases in preload-recruitable stroke-work with propofol (P < .001), desflurane (P < .001), and desflurane-and-propofol (P < .001) groups, but no evidence of increases with pentobarbitone (P = .576) and desflurane-then-propofol (P = .374). In terms of end-diastolic pressure–volume relationship, there was no evidence of increase compared to nonischemic controls with desflurane-then-propofol (P = .364), a small but significant increase with desflurane (P < .001), and larger increases with pentobarbitone (P < .001), propofol (P < .001), and desflurane-and-propofol (P < .001).
In rat hearts, there was no statistically significant difference in mitochondrial 3H-activity between propofol and desflurane-and-propofol (165 ± 51 × 10−5 vs 154 ± 51 × 10−5 g·mL·min/μmol; P = .998). Desflurane had lower uptake than propofol (65 ± 21 × 10−5 vs 165 ± 51 × 10−5 g·mL·min/μmol; P = .039), but there was no statistically significant difference between desflurane and desflurane-then-propofol (65 ± 21 × 10−5 vs 59 ± 11 × 10−5 g·mL·min/μmol; P = .999).

CONCLUSIONS:
Propofol and desflurane are cardioprotective, but desflurane is more effective than propofol. The added benefit of desflurane is lost when used simultaneously with propofol.
Perioperative Management in Hepatic Resections: Comparative Effectiveness of Neuraxial Anesthesia and Disparity of Care Patterns
Authors: Zerillo Jeron , Agarwal Parul , Poeran Jashvant , Zubizarreta Nicole , Poultsides George , Schwartz Myron , Memtsoudis Stavros , Mazumdar Madhu , DeMaria Samuel 
Published: June 2018

BACKGROUND:
Complication rates after hepatic resection can be affected by management decisions of the hospital care team and/or disparities in care. This is true in many other surgical populations, but little study has been done regarding patients undergoing hepatectomy.

METHODS:
Data from the claims-based national Premier Perspective database were used for 2006 to 2014. The analytical sample consisted of adults undergoing partial hepatectomy and total hepatic lobectomy with anesthesia care consisting of general anesthesia (GA) only or neuraxial and GA (n = 9442). The key independent variable was type of anesthesia that was categorized as GA versus GA + neuraxial. The outcomes examined were clinical complications and health care resource utilization. Unadjusted bivariate and adjusted multivariate analyses were conducted to examine the effects of the different types of anesthesia on clinical complications and health care resource utilization after controlling for patient- and hospital-level characteristics.

RESULTS:
Approximately 9% of patients were provided with GA + neuraxial anesthesia during hepatic resection. In multivariate analyses, no association was observed between types of anesthesia and clinical complications and/or health care utilization (eg, admission to intensive care unit). However, patients who received blood transfusions were significantly more likely to have complications and intensive care unit stays. In addition, certain disparities of care, including having surgery in a rural hospital, were associated with poorer outcomes.

CONCLUSIONS:
Neuraxial anesthesia utilization was not associated with improvement in clinical outcome or cost among patients undergoing hepatic resections when compared to patients receiving GA alone. Future research may focus on prospective data sources with more clinical information on such patients and examine the effects of GA + neuraxial anesthesia on various complications and health care resource utilization.
Variable Ventilation Associated With Recruitment Maneuver Minimizes Tissue Damage and Pulmonary Inflammation in Anesthetized Lung-Healthy Rats
Authors: Camilo Luciana Moisés , Motta-Ribeiro Gabriel Casulari , de Ávila Mariana Barcellos , Paula Luis Felipe Santos Cruz , de Abreu Mariana Boechat , Carvalho Alysson Roncally , Zin Walter Araujo 
Published: June 2018

BACKGROUND:
Recruitment maneuver and positive end-expiratory pressure (PEEP) can be used to counteract intraoperative anesthesia-induced atelectasis. Variable ventilation can stabilize lung mechanics by avoiding the monotonic tidal volume and protect lung parenchyma as tidal recruitment is encompassed within the tidal volume variability.

METHODS:
Forty-nine (7 per group) male Wistar rats were anesthetized, paralyzed, and mechanically ventilated. A recruitment maneuver followed by stepwise decremental PEEP titration was performed while continuously estimating respiratory system mechanics using recursive least squares. After a new recruitment, animals were ventilated for 2 hours in volume-control with monotonic (VCV) or variable (VV) tidal volumes. PEEP was adjusted at a level corresponding to the minimum elastance or 2 cm H2O above or below this level. Lungs were harvested for histologic analysis (left lung) and cytokines measurement (right lung). Seven animals were euthanized before the first recruitment as controls.

RESULTS:
A time-dependent increase in respiratory system elastance was observed and significantly minimized by PEEP (P < .001). Variable ventilation attenuated the amount of concentrations of proinflammatory mediators in lung homogenate: neutrophil cytokine-induced neutrophil chemoattractant 1 (VV = 40 ± 5 and VCV = 57 ± 8 pg/mg; P < .0001) and interleukin-1β (VV = 59 ± 25 and VCV = 261 ± 113 pg/mg; P < .0001). Variable ventilation was also associated with lower structural lung parenchyma damage. Significant reductions in air fraction at dorsal and caudal lung regions were observed in all ventilated animals (P < .001).

CONCLUSIONS:
Variable ventilation was more protective than conventional ventilation within the applied PEEP levels.
Electroencephalographic Arousal Patterns Under Dexmedetomidine Sedation
Authors: Sleigh Jamie W. , Vacas Susana , Flexman Alana M. , Talke Pekka O. 
Published: June 2018

BACKGROUND:
The depth of dexmedetomidine-induced sedation is difficult to assess without arousing the patient. We evaluated frontal electroencephalogram (EEG) as an objective measure of dexmedetomidine-induced sedation. Our aims were to characterize the response patterns of EEG during a wide range of dexmedetomidine-induced sedation and to determine which spectral power best correlated with assessed levels of dexmedetomidine-induced sedation.

METHODS:
Sedline EEG sensor was positioned on the forehead of 16 volunteers. Frontal EEG data were collected at 250 Hz using the Sedline monitor. A computer-controlled infusion pump was used to infuse dexmedetomidine to four 15-minute target plasma concentrations of 0.3, 0.6, 1.2, and 2.4 ng/mL. Arterial blood samples for dexmedetomidine plasma concentration and sedation (self-reported numerical rating scale) and arousal were measured at baseline and at the end of each infusion step. The EEG signal was used to estimate spectral power in sequential 4-second data segments with 75% overlap for 3 power bands: delta = 0.5–1.5 Hz, alpha = 9–14 Hz, beta = 15–24 Hz. We quantified the relationships among the plasma concentrations of dexmedetomidine, level of sedation, and various EEG parameters.

RESULTS:
EEG data at the end of the dexmedetomidine infusion steps show progressive loss of high frequencies (beta) and increase in alpha and delta powers, with increasing dexmedetomidine concentrations. Beta prearousal spectral power was best in predicting dexmedetomidine-induced level of sedation (R = −0.60, 95% CI, −0.43 to −0.75). The respective values for delta and alpha powers were R = 0.28 (95% CI, 0.03–0.45) and R = 0.16 (95% CI, −0.09 to 0.38). When the beta power has dropped below −16 dB or the delta power is above 15 dB, the subjects show moderate to deep levels of sedation. When awakening the subject, there is a reduction in power in the delta and alpha bands at the 0.6, 1.2, and 2.4 ng/mL dexmedetomidine target levels (P < .001 for all). In beta band, there is a rapid awakening-induced increase in power (P < .001) followed by a slow return toward baseline values. After arousing the subjects, the EEG powers returned toward baseline values significantly slower than our clinical observation of the subjects’ wakefulness would have suggested.

CONCLUSIONS:
Using a wide range of dexmedetomidine doses, we found that frontal EEG beta power of less than −16 dB and/or a delta power of over 15 dB was associated with a state of moderate to deep sedation and that poststimulus return of EEG powers toward baseline values took significantly longer than expected from observation of the arousal response. It is unclear whether these observations are robust enough for clinical applicability.
Adaptations to deep and prolonged diving in phocid seals
Authors: Blix Arnoldus Schytte 
Published: June 2018

ABSTRACTThis Review focuses on the original papers that have made a difference to our thinking and were first in describing an adaptation to diving, and less on those that later repeated the findings with better equipment. It describes some important anatomical peculiarities of phocid seals, as well as their many physiological responses to diving. In so doing, it is argued that the persistent discussions on the relevance and differences between responses seen in forced dives in the laboratory and those during free diving in the wild are futile. In fact, both are two sides of the same coin, aimed at protecting the body against asphyxic insult and extending diving performance.
Handgrip Strength, Function, and Mortality in Older Adults: A Time-varying Approach
Authors: MCGRATH RYAN P. , VINCENT BRENDA M. , LEE I-MIN , KRAEMER WILLIAM J. , PETERSON MARK D. 
Published: June 2018

ABSTRACT

Purpose
To determine the time-varying associations between 1) decreased handgrip strength and disabilities in each activity of daily living (ADL) function, and 2) disaggregated ADL limitations and time to mortality in older adults.

Methods
A United States nationally representative sample of 17,747 older adults from the Health and Retirement Study were followed up for 8 yr. Maximal handgrip strength was measured with a hand-held dynamometer. Ability to perform ADL was self-reported. Date of death was identified by the National Death Index and exit interviews. Separate covariate-adjusted hierarchical logit models were used to examine the time-varying associations between decreased handgrip strength and each ADL outcome. Distinct covariate-adjusted Cox models were used to analyze the time-varying associations between disaggregated ADL limitations and time to mortality.

Results
Every 5-kg decrease in handgrip strength was associated with increased odds for the following ADL limitations: 20% for eating, 14% for walking, 14% for bathing, 9% for dressing, 8% for transferring, and 6% for toileting. The presence of a bathing, walking, toileting, eating, and dressing ADL disability was associated with a 47%, 43%, 32%, 30%, and 19% higher hazard for mortality, respectively. A transferring ADL disability was not significantly associated with mortality.

Conclusions
Decreased handgrip strength was associated with increased odds for each ADL limitation, and in turn, most individual ADL impairments were associated with a higher hazard for mortality in older adults. These findings provide insights into the disabling process by identifying which ADL limitations are most impacted by decreased handgrip strength and the subsequent time to mortality for each ADL disability.
Impact of a Graded Exercise Program on V˙O2peak and Survival in Heart Failure Patients
Authors: SNOEK JOHAN A. , EIJSVOGELS THIJS M. H. , VAN ‘T HOF ARNOUD W. J. , PRESCOTT EVA , HOPMAN MARIA T. , KOLKMAN EVELIEN , DE KLUIVER ED P. 
Published: June 2018

ABSTRACT

Introduction
Although exercise therapy has the potential to improve health outcomes of patients with chronic heart failure (CHF), less than 50% of patients adhere to prescribed physical activity guidelines 1 yr after cardiac rehabilitation. We aimed to assess the effects of an extended cardiac rehabilitation program with 12 months of graded exercise therapy (GET) and resistance exercise training (RT) on exercise capacity and long-term survival in patients with CHF.

Methods
This prospective cohort study included 60 CHF patients between 2009 and 2010. The GET-RT program consisted of exercise sessions at 6 d·wk−1. Total training time of aerobic exercises increased incrementally every other week without changing exercise intensity. Resistance exercise training consisted of 8 exercises with a durable resistance band. Guidance consisted of a step-down approach from in-hospital to home-based training. Cardiopulmonary exercise tests were performed at baseline, 3, 6, and 12 months. Subsequently, patients were propensity score matched on a 1:2 ratio with controls (n = 117) from a CHF registry of patients from the same clinic receiving usual out-patient care and the incidence of all-cause mortality was compared between both groups.

Results
Baseline V˙O2 peak was 15.0 mL·min−1·kg−1 and significantly elevated at 3 months (+1.1 mL·min−1·kg−1 (95% CI, 0.4–1.8), 6 months (+2.9 mL·min−1·kg−1 (95% CI, 1.1–2.9) and 12 months (+2.6 mL·min−1·kg−1 (95% CI, 1.4–3.8). During 8 yr of follow-up 23 (38.3%) patients of the GET-RT program died versus 63 (53.8%) patients of the control group (P = 0.063).

Conclusions
The 12-month GET-RT program was associated with an improved fitness during 1-yr follow-up, whereas a tendency toward better survival rates was observed during long-term follow-up.
Gait Biomechanics in Anterior Cruciate Ligament–reconstructed Knees at Different Time Frames Postsurgery
Authors: GOETSCHIUS JOHN , HERTEL JAY , SALIBA SUSAN A. , BROCKMEIER STEPHEN F. , HART JOSEPH M. 
Published: June 2018

ABSTRACT

Purpose
To examine knee and hip biomechanics during walking and jogging in groups of ACLR patients at early, mid, and late time frames postsurgery and healthy controls.

Methods
Participants included individuals with a history of primary, unilateral ACLR, stratified into early (1.4 ± 0.4 yr post, n = 18), mid (3.3 ± 0.6 yr post, n = 20), and late (8.5 ± 2.8 yr post, n = 20) ACLR groups based on time postsurgery, and a healthy control group (n = 20). Walking and jogging motion capture analysis of knee and hip kinetics and kinematics were measured in the sagittal and frontal planes. Interlimb (within groups) and between-group comparisons were performed for all gait variables. Statistical comparisons were made across the gait cycle by plotting graphs of means and 90% confidence intervals and identifying regions of the gait cycle in which the 90% confidence intervals did not overlap.

Results
Early ACLR group demonstrated reduced knee flexion, knee extension, knee adduction, and hip adduction moments on the ACLR limb. Mid ACLR group demonstrated no gait differences between limbs or other groups. Late ACLR group demonstrated reduced knee flexion moments, and greater knee and hip adduction moments in their ACLR limb. Control group demonstrated no interlimb differences.

Conclusions
Walking and jogging gait biomechanics presented differently in patients at different stages in time after ACLR surgery. The early ACLR group demonstrated lower sagittal and frontal plane joint loading on the ACLR limb compared with contralateral and control limbs. The mid ACLR group did not demonstrate any gait differences compared with the contralateral or control limb. The late ACLR group demonstrated lower sagittal plane joint loading compared with control limbs and greater frontal plane joint loading compared to contralateral and control limbs.
High-Intensity Interval Training Augments Muscle Carnosine in the Absence of Dietary Beta-alanine Intake
Authors: DE SALLES PAINELLI VITOR , NEMEZIO KLEINER MÁRCIO , PINTO ANA JÉSSICA , FRANCHI MARIANA , ANDRADE ISABEL , RIANI LUIZ AUGUSTO , SAUNDERS BRYAN , SALE CRAIG , HARRIS ROGER CHARLES , GUALANO BRUNO , ARTIOLI GUILHERME GIANNINI 
Published: June 2018

ABSTRACT

Purpose
Cross-sectional studies suggest that training can increase muscle carnosine (MCarn), although longitudinal studies have failed to confirm this. A lack of control for dietary β-alanine intake or muscle fiber type shifting may have hampered their conclusions. The purpose of the present study was to investigate the effects of high-intensity interval training (HIIT) on MCarn.

Methods
Twenty vegetarian men were randomly assigned to a control (CON) (n = 10) or HIIT (n = 10) group. High-intensity interval training was performed on a cycle ergometer for 12 wk, with progressive volume (6–12 series) and intensity (140%–170% lactate threshold [LT]). Muscle carnosine was quantified in whole-muscle and individual fibers; expression of selected genes (CARNS, CNDP2, ABAT, TauT, and PAT1) and muscle buffering capacity in vitro (βm
in vitro
) were also determined. Exercise tests were performed to evaluate total work done, V˙O2max, ventilatory thresholds (VT) and LT.

Results
Total work done, VT, LT, V˙O2max, and βm
in vitro
were improved in the HIIT group (all P < 0.05), but not in CON (P > 0.05). MCarn (in mmol·kg−1 dry muscle) increased in the HIIT (15.8 ± 5.7 to 20.6 ± 5.3; P = 0.012) but not the CON group (14.3 ± 5.3 to 15.0 ± 4.9; P = 0.99). In type I fibers, MCarn increased in the HIIT (from 14.4 ± 5.9 to 16.8 ± 7.6; P = 0.047) but not the CON group (from 14.0 ± 5.5 to 14.9 ± 5.4; P = 0.99). In type IIa fibers, MCarn increased in the HIIT group (from 18.8 ± 6.1 to 20.5 ± 6.4; P = 0.067) but not the CON group (from 19.7 ± 4.5 to 18.8 ± 4.4; P = 0.37). No changes in gene expression were shown.

Conclusions
In the absence of any dietary intake of β-alanine, HIIT increased MCarn content. The contribution of increased MCarn to the total increase in βm
in vitro
appears to be small.
Oral aniracetam treatment in C57BL/6J mice without pre-existing cognitive dysfunction reveals no changes in learning, memory, anxiety or stereotypy
Authors: Reynolds Conner D. , Jefferson Taylor S. , Volquardsen Meagan , Pandian Ashvini , Smith Gregory D. , Holley Andrew J. , Lugo Joaquin N. 
Published: June 2018

Background: The piracetam analog, aniracetam, has recently received attention for its cognition enhancing potential, with minimal reported side effects. Previous studies report the drug to be effective in both human and non-human models with pre-existing cognitive dysfunction, but few studies have evaluated its efficacy in healthy subjects. A previous study performed in our laboratory found no cognitive enhancing effects of oral aniracetam administration 1-hour prior to behavioral testing in naïve C57BL/6J mice. Methods: The current study aims to further evaluate this drug by administration of aniracetam 30 minutes prior to testing in order to optimize any cognitive enhancing effects. In this study, all naïve C57BL/6J mice were tested in tasks of delayed fear conditioning, novel object recognition, rotarod, open field, elevated plus maze, and marble burying. Results: Across all tasks, animals in the treatment group failed to show enhanced learning when compared to controls. Conclusions: These results provide further evidence suggesting that aniracetam conveys no therapeutic benefit to subjects without pre-existing cognitive dysfunction.
Spectrum of Pituitary disorders: A retrospective study from Basrah, Iraq
Authors: Mansour Abbas Ali , Alhamza Ali Hussain Ali , Almomin Ammar Mohammed Saeed Abdullah , Zaboon Ibrahim Abbood , Alibrahim Nassar Taha Yaseen , Hussein Rudha Naser , Kadhim Muayad Baheer , Alidrisi Haider Ayad Yassin , Nwayyir Hussein Ali , Mohammed Adel Gassab , Al-Waeli Dheyaa Kadhim , Hussein Ibrahim Hani 
Published: June 2018

Background:Pituitary disorders spectrum includes a wide variety of diseases.This study aimed at a comprehensive description of such disorders for patients from Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Basrah (Southern Iraq).Methods: Retrospective data analysis of FDEMC for the period from January 2012 through June 2017. We included all patients with pituitary disorders who have MRI pituitary.Results: The pituitary disorders were more common among women. Those with macroadenoma were older than those with microadenoma with nearly equal gender prevalence of macroadenoma. Pituitary adenoma constituted the bulk of pituitary disorders in this registry (67.2%). Growth hormone secreting adenoma were the commonest adenoma seen in 41.0% followed by clinically non-functioning pituitary adenoma(NFPA)in 31.4% and prolactinoma in 26.9%. About 64.8% of pituitary adenoma was macroadenoma. Macroadenoma was seen in 73.4 % of growth hormone secreting adenoma, 61.2% in NFPA and 62.0% of prolactinoma (of them six were giant prolactinoma)Conclusion: Pituitary adenoma constituted the bulk of pituitary disorders in Basrah, growth hormone secreting adenoma is the commonest adenoma followed by NFPA and prolactinoma due to referral bias. A change in practice of pituitary adenoma treatment is needed.
Fuchs heterochromic iridocyclitis-associated glaucoma: a retrospective comparison of primary Ahmed glaucoma valve implantation and trabeculectomy with mitomycin C
Authors: Esfandiari Hamed , Loewen Nils A. , Hassanpour Kiana , Fatourechi Ali , Yazdani Shahin , Wang Chao , Yaseri Mehdi , Pakravan Mohammad 
Published: June 2018

Background: The aim of this study was to compare the safety and efficacy of primary trabeculectomy with mitomycin C and Ahmed glaucoma valve (AGV) implantation in patients with Fuchs heterochromic iridocyclitis (FHIC)-related glaucoma, a rare complication of an uncommon form of uveitis. Methods: In this retrospective comparative case series, 26 FHIC-associated glaucoma patients received trabeculectomy (n=12) or an AGV (n=14). Primary outcome measures were surgical success, defined as intraocular pressure (IOP) ≤21 mmHg, decreasing ≥20% from baseline, and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity (BCVA), and IOP. Results: The follow-up was 34.0±17.7 months in patients that received trabeculectomy and 33.4±18.6 months in AGV (P= 0.837). The cumulative probability of success rate was 41.7% for trabeculectomy and 85.7% for AGV, with no significant difference in complications (P>0.05). The IOP in patients that received trabeculectomy dropped from 23.4±3.3 mmHg to 21.6±5.2 mmHg at the final visit (P= 0.041). In patients that received AGV, the IOP decreased from 24±7.8 to 17.1±2.6 mmHg (P= 0.003). The number of glaucoma medications at baseline were 3.3±0.5 in those that received trabeculectomy and 3±0.6 in those that received AGV (P=0.233), and decreased to 2.4±1.0 (P=0.008) and 1.7±0.6 (P=0.002), respectively. BCVA was equal in both groups and did not change (P>0.05). Conclusion: Primary AGV had a higher success rate than trabeculectomy, with patients also needing fewer medications for the management of FHIC-associated glaucoma.