bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Anesthetic Depth Indexes Based on Thalamocortical Local Field Potentials in Rats
Authors: Silva Aura , Cardoso-Cruz Hélder , Silva Francisco , Galhardo Vasco , Antunes Luís 
Published: January 2010

Background
Local field potentials may allow a more precise analysis of the brain electrical activity than the electroencephalogram. In this study, local field potentials were recorded in the thalamocortical axis of rats to (i) compare the performance of several indexes of anesthetic depth and (ii) investigate the existence of thalamocortical correlated or disrupted activity during isoflurane steady-state anesthesia.

Methods
Five rats chronically implanted with microelectrodes were used to record local field potentials in the primary somatosensory cortex and ventroposterolateral thalamic nuclei at six periods: before induction of anesthesia; in the last 5 min of randomized 20-min steady-state end-tidal 0.8, 1.1, 1.4, and 1.7% isoflurane concentrations; and after recovery. The approximate entropy, the index of consciousness, the spectral edge frequency, and the permutation entropy were estimated using epochs of 8 s. A correction factor for burst suppression was applied to the spectral edge frequency and to the permutation entropy. The correlation between the derived indexes and the end-tidal isoflurane was calculated and compared for the two studied brain regions indexes. Coherence analysis was also performed.

Results
The burst suppression-corrected permutation entropy showed the highest correlation with the end-tidal isoflurane concentration, and a high coherence was obtained between the two studied areas.

Conclusions
The permutation entropy corrected with the classic burst suppression ratio is a promising alternative to other indexes of anesthetic depth. Furthermore, high coherence level of activity exists between the somatosensory cortical and thalamic regions, even at deep isoflurane stages.
Phenyl N -tert-butylnitrone, a Free Radical Scavenger, Reduces Mechanical Allodynia in Chemotherapy-induced Neuropathic Pain in Rats
Authors: Kim Hee Kee , Zhang Yan Ping , Gwak Young Seob , Abdi Salahadin 
Published: January 2010

Background
Paclitaxel is a widely used chemotherapeutic drug for breast and ovarian cancer. Unfortunately, it induces neuropathic pain, which is a dose-limiting side effect. Free radicals have been implicated in many neurodegenerative diseases. The current study tests the hypothesis that a free radical scavenger plays an important role in reducing chemotherapy-induced neuropathic pain.

Methods
Neuropathic pain was induced by intraperitoneal injection of paclitaxel (2 mg/kg) on four alternate days (days 0, 2, 4, and 6) in male Sprague-Dawley rats. Phenyl N-tert-butylnitrone (PBN), a free radical scavenger, was administered intraperitoneally as a single dose or multiple doses before or after injury. Mechanical allodynia was measured by using von Frey filaments.

Results
The administration of paclitaxel induced mechanical allodynia, which began to manifest on days 7-10, peaked within 2 weeks, and plateaued for at least 2 months after the first paclitaxel injection. A single injection or multiple intraperitoneal injections of PBN ameliorated paclitaxel-induced pain behaviors in a dose-dependent manner. Further, multiple administrations of PBN starting on day 7 through day 15 after the first injection of paclitaxel completely prevented the development of mechanical allodynia. However, an intraperitoneal administration of pbn for 8 days starting with the first paclitaxel injection did not prevent the development of pain behavior.

Conclusions
This study clearly shows that PBN alleviated mechanical allodynia induced by paclitaxel in rats. Furthermore, our data show that PBN given on days 7 through 15 after the first paclitaxel injection prevented the development of chemotherapy-induced neuropathic pain. This clearly has a clinical implication.
Direct Evidence for the Ongoing Brain Activation by Enhanced Dynorphinergic System in the Spinal Cord under Inflammatory Noxious Stimuli
Authors: Taketa Yasuko , Niikura Keiichi , Kobayashi Yasuhisa , Furuya Masaharu , Shimizu Toshikazu , Narita Michiko , Imai Satoshi , Kuzumaki Naoko , Maitani Yoshie , Yamazaki Mitsuaki , Inada Eiichi , Iseki Masako , Suzuki Tsutomu , Narita Minoru 
Published: January 2010

Background
Dynorphin A in the spinal cord is considered to contribute to nociceptive stimuli. However, it has not yet been determined whether activation of the spinal dynorphinergic system under nociceptive stimuli plays a role in direct acceleration of the ascending nociceptive pathway. In this study, the authors investigated the role of spinal dynorphinergic transmission in ongoing brain activation under noxious stimuli in mice.

Methods
The changes in prodynorphin messenger RNA expression and dynorphin A (1-17)-like immunoreactivity in the mouse spinal cord were determined after the intraplantar injection of complete Freund's adjuvant in mice. The signal intensity in different brain regions after the intraplantar injection of complete Freund's adjuvant or intrathecal injection of dynorphin A (1-17) was measured by a pharmacological functional magnetic resonance imaging analysis.

Results
Complete Freund's adjuvant injection produced pain-associated behaviors and induced a dramatic increase in signal intensity in the mouse cingulate cortex, somatosensory cortex, insular cortex, and thalamic nuclei. These effects were not seen in prodynorphin knockout mice. Prodynorphin messenger RNA expression and dynorphin A (1-17)-like immunoreactivity on the ipsilateral side of the spinal cord were markedly increased in complete Freund's adjuvant-injected mice. Furthermore, intrathecal injection of dynorphin A (1-17) at relatively high doses caused pain-associated behaviors and a remarkable increase in the activities of the cingulate cortex, somatosensory cortex, insular cortex, and medial and lateral thalamic nuclei in mice.

Conclusions
These findings indicate that spinally released dynorphin A (1-17) by noxious stimuli leads to the direct activation of ascending pain transmission.
Isoflurane Does Not Affect Brain Cell Death, Hippocampal Neurogenesis, or Long-term Neurocognitive Outcome in Aged Rats
Authors: Stratmann Greg , Sall Jeffrey W. , Bell Joseph S. , Alvi Rehan S. , May Laura d. V. , Ku Ban , Dowlatshahi Mitra , Dai Ran , Bickler Philip E. , Russell Isobel , Lee Michael T. , Hrubos Margit W. , Chiu Cheryl 
Published: January 2010

Background
Roughly, 10% of elderly patients develop postoperative cognitive dysfunction. General anesthesia impairs spatial memory in aged rats, but the mechanism is not known. Hippocampal neurogenesis affects spatial learning and memory in rats, and isoflurane affects neurogenesis in neonatal and young adult rats. We tested the hypothesis that isoflurane impairs neurogenesis and hippocampal function in aged rats.

Methods
Isoflurane was administered to 16-month-old rats at one minimum alveolar concentration for 4 h. FluoroJade staining was performed to assess brain cell death 16 h after isoflurane administration. Dentate gyrus progenitor proliferation was assessed by bromodeoxyuridine injection 4 days after anesthesia and quantification of bromodeoxyuridine+ cells 12 h later. Neuronal differentiation was studied by determining colocalization of bromodeoxyuridine with the immature neuronal marker NeuroD 5 days after anesthesia. New neuronal survival was assessed by quantifying cells coexpressing bromodeoxyuridine and the mature neuronal marker NeuN 5 weeks after anesthesia. Four months after anesthesia, associative learning was assessed by fear conditioning. Spatial reference memory acquisition and retention was tested in the Morris Water Maze.

Results
Cell death was sporadic and not different between groups. We did not detect any differences in hippocampal progenitor proliferation, neuronal differentiation, new neuronal survival, or in any of the tests of long-term hippocampal function.

Conclusion
In aged rats, isoflurane does not affect brain cell death, hippocampal neurogenesis, or long-term neurocognitive outcome.
Coding of Incisional Pain in the Brain
Authors: Pogatzki-Zahn Esther M. , Wagner Christian , Meinhardt-Renner Anne , Burgmer Markus , Beste Christian , Zahn Peter K. , Pfleiderer Bettina 
Published: January 2010

Introduction
In this study, the activation of different brain areas after an experimental surgical incision was assessed by functional magnetic resonance imaging, and the pathophysiological role of distinct brain activation patterns for pain perception after incision was analyzed.

Methods
Thirty male volunteers (mean age +/-SD, 25+/- 5 yr) received an experimental incision (4 mm) within the volar aspect of the right forearm using a ceramic scalper blade, and 14 volunteers (mean age +/- SD, 25 +/- 4 yr) received a sham procedure. Magnetic resonance images were taken before, during (0-2 min), and after incision or sham procedure (2-4.5, 4.5-10, 24-29, and 44-49 min) at a 3T scanner using a block design. Subjective pain ratings by a numerical pain scale were performed between the scans.

Results
Functional magnetic resonance imaging analysis showed a distinct temporal profile of activity within specific brain regions during and after the injury. Lateralization (predominantly contralateral to the incision) and increased brain activity of the somatosensory cortex, frontal cortex, and limbic system were observed in subjects after incision, when compared with individuals receiving sham procedure. Peak brain activation occurred about 2 min after incision and decreased subsequently. A distinct correlation between evoked pain ratings and brain activity was observed for the anterior cingulate cortex, insular cortex, thalamus, frontal cortex, and somatosensory cortex.

Conclusion
These findings show different and distinct cortical and subcortical activation patterns over a relevant time period after incision. Pain sensitivity hereby has an influence on the activity profile. This may have important implications for encoding ongoing pain after a tissue injury, for example, resting pain in postoperative patients.
Continuous Peripheral Nerve Blocks
Authors: Ilfeld Brian M. , Moeller Lisa K. , Mariano Edward R. , Loland Vanessa J. , Stevens-Lapsley Jennifer E. , Fleisher Adam S. , Girard Paul J. , Donohue Michael C. , Ferguson Eliza J. , Ball Scott T. 
Published: January 2010

Background
The main determinant of continuous peripheral nerve block effects--local anesthetic concentration and volume or simply total drug dose--remains unknown.

Methods
We compared two different concentrations and basal rates of ropivacaine--but at equivalent total doses--for continuous posterior lumbar plexus blocks after hip arthroplasty. Preoperatively, a psoas compartment perineural catheter was inserted. Postoperatively, patients were randomly assigned to receive perineural ropivacaine of either 0.1% (basal 12 ml/h, bolus 4 ml) or 0.4% (basal 3 ml/h, bolus 1 ml) for at least 48 h. Therefore, both groups received 12 mg of ropivacaine each hour with a possible addition of 4 mg every 30 min via a patient-controlled bolus dose. The primary endpoint was the difference in maximum voluntary isometric contraction (MVIC) of the ipsilateral quadriceps the morning after surgery, compared with the preoperative MVIC, expressed as a percentage of the preoperative MVIC. Secondary endpoints included hip adductor and hip flexor MVIC, sensory levels in the femoral nerve distribution, hip range-of-motion, ambulatory ability, pain scores, and ropivacaine consumption.

Results
Quadriceps MVIC for patients receiving 0.1% ropivacaine (n = 26) declined by a mean (SE) of 64.1% (6.4) versus 68.0% (5.4) for patients receiving 0.4% ropivacaine (n = 24) between the preoperative period and the day after surgery (95% CI for group difference: -8.0-14.4%; P = 0.70). Similarly, the groups were found to be equivalent with respect to secondary endpoints.

Conclusions
For continuous posterior lumbar plexus blocks, local anesthetic concentration and volume do not influence nerve block characteristics, suggesting that local anesthetic dose (mass) is the primary determinant of perineural infusion effects.
Characterization of the Postconditioning Effect of Dexmedetomidine in Mouse Organotypic Hippocampal Slice Cultures Exposed to Oxygen and Glucose Deprivation
Authors: Dahmani Souhayl , Rouelle Danielle , Gressens Pierre , Mantz Jean 
Published: January 2010

Background
There is an increasing interest in the use of dexmedetomidine for anesthesia and sedation. Here, we used the mouse organotypic hippocampal slice culture to investigate whether dexmedetomidine exhibits postconditioning properties against oxygen and glucose deprivation (OGD). The role of the focal adhesion and extracellular-regulated kinases pathways in these effects were examined in both postconditioning and preconditioning.

Materials and Methods
Slices were obtained from P5 mouse. In postconditioning experiments, Dexmedetomidine (1 microm) was incubated 60 min after the end of OGD. In preconditioning experiments, dexmedetomidine was applied 3 h before OGD. Pharmacologic modulation of the studied pathways was achieved by using selective inhibitors of these cascades. Cell death was assessed 72 h after OGD using propidium iodide labeling and protein expression of activated caspase 3.

Results
Maximum cell death increased with the duration of OGD. Dexmedetomidine induced a postconditioning effect in the CA1 (but not dentate gyrus) subfield area, which was significantly reduced by modulators of the focal adhesion and the extracellular-regulated kinases pathways. The combination of the inhibitors of the two pathways completely abolished the postconditioning effect of dexmedetomidine. The preconditioning effect of dexmedetomidine against ischemia-induced injury was observed in all hippocampal subfield areas. Results obtained with the pharmacologic modulation used for postconditioning also applied to dexmedetomidine-induced preconditioning.

Discussion
Dexmedetomidine exhibits significant, but moderate, postconditioning properties against oxygen and glucose deprivation-induced injury. Activation of focal adhesion and the imidazoline 1 receptors-extracellular-regulated kinases pathways is involved in dexmedetomidine-induced postconditioning and preconditioning as well.
Factor VII Levels and International Normalized Ratios in the Early Phase of Warfarin Therapy
Authors: Benzon Honorio T. , Avram Michael J. , Benzon Hubert A. , Kirby-Nolan Misty , Nader Antoun 
Published: January 2010

Background
Factor VII is the most affected clotting factor during the early phase of warfarin therapy. An international normalized ratio (INR) of more than 1.4 is considered unsafe for epidural catheter placement or removal, according to the American Society of Regional Anesthesia and Pain Medicine. The authors tested the hypothesis that factor VII activities would be consistent with safe removal of the epidural catheter on postoperative day (POD) 1 regardless of INR value.

Methods
Data from 121 patients who took warfarin after undergoing total joint surgery and had INRs and factor VII levels determined were reviewed. Patient characteristics and factor VII activities were compared between patients with INRs of more than 1.4 and those with INRs less than or equal to 1.4 on PODs 1, 2, and 3.

Results
Eleven patients had INRs of more than 1.4 on POD 1; their mean +/- SD factor VII activities were 60 +/- 28% (normal: 50-160%). On POD 2, 78 patients with INRs more than of 1.4 had factor VII activities of 32 +/- 15%, whereas on POD 3, 84 patients with INRs of more than 1.4 had factor VII activities of 44 +/- 19%. Variables included in the final multiple logistic regression model as predictors of an INR of more than 1.4 on POD 2 were warfarin dose on POD 1 and factor VII activity on POD 2.

Conclusions
The range of factor VII activities in the patients with INRs of more than 1.4 within 12 h of warfarin therapy was compatible with adequate hemostasis. The authors found no evidence that epidural catheters should not be removed even with INRs up to 1.9, the highest INR on POD 1 noted in their study.
Impact of Pulse Oximetry Surveillance on Rescue Events and Intensive Care Unit Transfers
Authors: Taenzer Andreas H. , Pyke Joshua B. , McGrath Susan P. , Blike George T. 
Published: January 2010

Background
Some preventable deaths in hospitalized patients are due to unrecognized deterioration. There are no publications of studies that have instituted routine patient monitoring postoperatively and analyzed impact on patient outcomes.

Methods
The authors implemented a patient surveillance system based on pulse oximetry with nursing notification of violation of alarm limits via wireless pager. Data were collected for 11 months before and 10 months after implementation of the system. Concurrently, matching outcome data were collected on two other postoperative units. The primary outcomes were rescue events and transfers to the intensive care unit compared before and after monitoring change.

Results
Rescue events decreased from 3.4 (1.89-4.85) to 1.2 (0.53-1.88) per 1,000 patient discharges and intensive care unit transfers from 5.6 (3.7-7.4) to 2.9 (1.4-4.3) per 1,000 patient days, whereas the comparison units had no change.

Conclusions
Patient surveillance monitoring results in a reduced need for rescues and intensive care unit transfers.
Meconium Ileus in Patients With Cystic Fibrosis Is Not a Risk Factor for Clinical Deterioration and Survival: The Israeli Multicenter Study
Authors: Efrati Ori , Nir Judith , Fraser Drora , Cohen‐Cymberknoh Malena , Shoseyov David , Vilozni Daphna , Modan‐Moses Dalit , Levy Ran , Szeinberg Amir , Kerem Eitan , Rivlin Joseph 
Published: January 2010

ABSTRACTObjectives:Patients with cystic fibrosis (CF) presenting with meconium ileus (MI) tend to have worse outcomes than those without MI. We evaluated the clinical characteristics and survival rates among Israeli patients with CF with and without MI after a prolonged follow‐up (15–30 years).Patients and Methods:A multicenter retrospective study. Forty‐nine patients with CF, representing 13.8% of all patients with CF in Israel, presented with MI (current age 17.4 ± 7.9 years) between 1975 and 2006. They were compared with 38 patients with CF (current age 19.3 ± 6.5 years) without MI matched by sex and CF transmembrane conductance regulator mutation.Results:A total of 66.2% of patients with MI and 73.6% without MI were followed for a prolonged period (24.9 ± 2.7 years). Of the patients with MI, 31 were managed operatively, whereas 18 were treated successfully with gastrograffin enema, with similar clinical outcomes. Five patients in the MI group and 3 in the control group died during the study period. Bacterial colonization, z score of body mass index, and pulmonary function tests were similar in patients with and without MI in the long term. In younger patients, many clinical parameters were more prevalent in patients with MI (P = 0.004). However, these differences disappeared after the long‐term follow‐up (up to 31‐years).Conclusions:Patients with CF presenting with MI had similar pulmonary function and nutritional status, as well as survival rates as did the control patients without MI. The distinct genetic mutation found in our population may explain in part the favorable results compared with other studies. In addition, it seems that early diagnosis and treatment of MI in patients with CF may be beneficial, subsequently lowering morbidity, and increasing survival.
Comparison of Esophageal pH and Multichannel Intraluminal Impedance Testing in Pediatric Patients With Suspected Gastroesophageal Reflux
Authors: Francavilla Ruggiero , Magistà Anna Maria , Bucci Nunzia , Villirillo Antonietta , Boscarelli Giuseppe , Mappa Luigi , Leone Gilda , Fico Stefania , Castellaneta Stefania , Indrio Flavia , Lionetti Elena , Moramarco Fulvio , Cavallo Luciano 
Published: January 2010

ABSTRACTBackground:Multichannel intraluminal impedance (MII) is a pH‐independent method of assessing gastroesophageal reflux.Aim:To evaluate the diagnostic accuracy of MII‐pH as compared with conventional pH monitoring in detecting reflux events (REs) and symptom association in different age groups.Methods:A prospective direct comparison of 2 diagnostic techniques on 291 consecutive patients referred for suspected gastroesophageal reflux disease. Sensitivity and diagnostic accuracy of MII‐pH versus pH monitoring and symptom association were measured.Results:MII‐pH detected 13631 REs, 6260 (46%) of which were nonacid. The prevalence of weakly acid refluxes in the 24 hours and postprandial period as well as the proximal extension of refluxate were significantly greater in infants as compared with children (P < 0.001, P < 0.001, and P < 0.01, respectively). The diagnostic accuracy of combined MII‐pH in revealing all RE and acid RE were significantly higher in infants as compared with children (92% vs 82%, P < 0.01 and 83% vs 76%, P < 0.04, respectively). The addition of MII to conventional pH monitoring significantly increases the diagnostic yield of symptom association analysis in revealing an association between atypical symptoms and refluxes irrespective of age, whereas in studying typical symptoms it was true only for infants.Conclusions:Addition of MII to conventional pH monitoring significantly increases the diagnostic yield in detecting REs, prevalently in infants, and in revealing an association between refluxes and symptoms, prevalently respiratory ones and in infants group.
Prediction of Clinical and Mucosal Severity of Coeliac Disease and Dermatitis Herpetiformis by Quantification of IgA/IgG Serum Antibodies to Tissue Transglutaminase
Authors: Dahlbom Ingrid , Korponay‐Szabó Ilma R , Kovács Judit B , Szalai Zsuzsanna , Mäki Markku , Hansson Tony 
Published: January 2010

ABSTRACTObjectives:We analysed whether the quantification of autoantibodies against tissue transglutaminase could be used to predict mucosal destruction and disease severity in patients with gluten sensitivity.Patients and Methods:One hundred seventy patients with coeliac disease (CD), comprising 52 children with severe malabsorption (group I), 59 children with mild symptoms (group II), 59 adults (group III), 134 patients with dermatitis herpetiformis (DH), and 131 disease controls, were studied. Serial serum samples of patients in groups I and II on a gluten‐free diet were also included. Serum levels of antibodies against recombinant tissue transglutaminase were determined with ELISA using standard curves for quantification of antibodies.Results:Immunoglobulin (Ig)A antibodies against tissue transglutaminase (IgA‐TGA) were detected in all of the patients with CD and in 95% of the DH patients. The IgA‐TGA and IgG‐TGA levels were higher in group I (P < 0.001). The IgG‐TGA levels and positivity rate in group I (100%) were higher than in group II (81%), group III (73%), and the DH group (67%). Elevated IgA‐TGA and IgG‐TGA levels in combination predicted a more severe small intestinal atrophy (P < 0.0001) with a specificity of 99% for Marsh IIIb–IIIc (flat) lesions. The kinetics of the IgA‐TGA decrease during diet differed between groups I and II.Conclusions:High levels of IgA‐TGA and IgG‐TGA antibodies were associated with the grade of mucosal villous atrophy and a more severe clinical presentation. The combined measurement of IgA‐TGA and IgG‐TGA enables a noninvasive prediction of small intestinal villous atrophy with high accuracy, and may reduce the need for a biopsy in patients with suspected CD.