bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upregulation of Prostaglandin E2and Interleukins in the Central Nervous System and Peripheral Tissue during and after Surgery in Humans
Authors: Buvanendran Asokumar , Kroin Jeffrey S. , Berger Richard A. , Hallab Nadim J. , Saha Chiranjeev , Negrescu Corina , Moric Mario , Caicedo Marco S. , Tuman Kenneth J. 
Published: February 2006

Background
The central and peripheral inflammatory response to surgery may influence patient outcomes. This study examines the time course and clinical relevance of changes in prostaglandin E2 and cytokines in cerebrospinal fluid, local tissue (surgical site), and circulating blood during and after total hip replacement.

Methods
Thirty osteoarthritis patients undergoing primary total hip arthroplasty with spinal anesthesia were randomly allocated to three groups (n = 10/group): placebo for 4 days before surgery and on the morning of surgery; placebo for 4 days before surgery and oral rofecoxib 50 mg on the morning of surgery; oral rofecoxib 50 mg for 4 days before surgery and the morning of surgery. Cerebrospinal fluid and plasma were collected before surgery and up to 30 h after incision for measurement of prostaglandin E2 and interleukins. When hip replacement was complete, a drain was placed in the hip wound and exudates were collected at 3 to 30 h after incision.

Results
Cerebrospinal fluid showed an initial increase in interleukin 6 and a later rise in prostaglandin E2 concentration after surgery; interleukin 1beta and tumor necrosis factor alpha were undetectable. Hip surgical site fluid evidenced an increase in prostaglandin E2, interleukin 6, interleukin 8, and interleukin 1beta; tumor necrosis factor alpha decreased at 24 and 30 h. Preoperative administration of the cyclooxygenase 2 inhibitor rofecoxib reduced cerebrospinal fluid and surgical site prostaglandin E2 and cerebrospinal fluid interleukin 6. Cerebrospinal fluid prostaglandin E2 was positively correlated with postoperative pain and cerebrospinal fluid interleukin 6 with sleep disturbance. Poorer functional recovery was positively correlated with increased surgical site prostaglandin E2.

Conclusions
These results suggest that upregulation of prostaglandin E2 and interleukin 6 at central sites is an important component of surgery induced inflammatory response in patients and may influence clinical outcome.
Multifactorial Preoperative Predictors for Postcesarean Section Pain and Analgesic Requirement
Authors: Pan Peter H. , Coghill Robert , Houle Timothy T. , Seid Melvin H. , Lindel W Michael , Parker R Lamar , Washburn Scott A. , Harris Lynne , Eisenach James C. 
Published: February 2006

Background
The study aimed to determine predictive factors for postcesarean pain and analgesia using an assessment of pain threshold and suprathreshold thermal stimuli as well as degree of somatization and anxiety.

Methods
Thirty-four healthy parturients scheduled for cesarean delivery under subarachnoid anesthesia were enrolled. Preoperative thermal pain threshold, intensity, and unpleasantness to heat stimuli applied to arm and lower back, State Trait Anxiety Inventory, and patient expectation for postoperative pain and need for analgesia were assessed. After surgery, overall, resting, and movement pain and analgesic consumption were recorded. Prediction of pain and analgesic use outcomes was made by principal component factor analysis, followed by stepwise linear regression.

Results
Resting pain was predicted by two factors, thermal pain and unpleasantness and patient expectation (r2 = 0.26, P < 0.01), evoked pain by thermal pain threshold in the back (r2= 0.20, P < 0.009), composite pain by thermal pain and unpleasantness and preoperative blood pressure (r2 = 0.28, P < 0.008), intraoperative analgesic need by preexisting pain (r2 = 0.22, P < 0.006), recovery room analgesia by thermal pain threshold and State Trait Anxiety Inventory (r2 = 0.27, P < 0.01), and total analgesic need by State Trait Anxiety Inventory (r2 = 0.22, P < 0.01). These models predicted the upper twentieth percentile of composite pain scores and analgesic requirement with sensitivity of 0.71 to 0.80 and specificity of 0.76 to 0.80.

Conclusions
The authors' results suggest a meaningful combination of preoperative patient responses from physical and psychological tests yields a valid multifactorial predictive model for postoperative pain and analgesic requirement with significant improvements over individual predictive variables.
Feasibility and Safety of Delivering Xenon to Patients Undergoing Coronary Artery Bypass Graft Surgery While on Cardiopulmonary Bypass
Authors: Lockwood Geoffrey G. , Franks Nicholas P. , Downie Neil A. , Taylor Kenneth M. , Maze Mervyn 
Published: February 2006

Background
Postoperative neurocognitive deficit is prevalent after cardiac surgery. Xenon may prevent or ameliorate acute neuronal injury, but it also may aggravate injury during cardiac surgery by increasing bubble embolism. Before embarking on a randomized clinical trial to test the safety and efficacy of xenon for postoperative neurocognitive deficit, we undertook a phase I study to investigate the safety of administering xenon to patients undergoing coronary artery bypass grafting while on cardiopulmonary bypass and to assess the practicability of our xenon delivery system.

Methods
Sixteen patients scheduled for coronary artery bypass grafting surgery with hypothermic cardiopulmonary bypass gave their informed consent to participate in an open-label dose-escalation study (0, 20, 35, 50% xenon in oxygen and air). Xenon was delivered throughout surgery using both a standard anesthetic breathing circuit and the oxygenator. Gaseous and blood xenon partial pressures were measured five times before, during, and after cardiopulmonary bypass. Middle cerebral artery Doppler was used to assess embolic load, and major organ system function was assessed before and after surgery.

Results
Middle cerebral artery Doppler showed no evidence of increased emboli with xenon. Patients receiving xenon had no major organ dysfunction: Troponin I and S100beta levels tended to be lower in patients receiving xenon. Up to 25 l xenon was used per patient. Xenon partial pressure in the blood tracked the delivered concentration throughout.

Conclusions
Xenon was safely and efficiently delivered to coronary artery bypass grafting patients while on cardiopulmonary bypass. Prevention of nervous system injury by xenon should be tested in a large placebo-controlled, randomized clinical trial.
Comparison of Minimum Alveolar Concentration between Intravenous Isoflurane Lipid Emulsion and Inhaled Isoflurane in Dogs
Authors: Yang Xiao-Lin , Ma Han-Xiang , Yang Zong-Bin , Liu Ai-Jie , Luo Nan-Fu , Zhang Wen-Sheng , Wang Li , Jiang Xue-Hua , Li Jie , Liu Jin 
Published: February 2006

Background
As in inhaled isoflurane anesthesia, when isoflurane lipid emulsion (ILE; 8%, vol/vol) is intravenously administered, the primary elimination route is through the lungs. This study was designed to determine the minimum alveolar concentration (MAC) and the time course of washout of isoflurane for intravenously infused ILE by monitoring end-tidal isoflurane concentration.

Methods
Twelve healthy adult mongrel dogs were assigned randomly to an intravenous anesthesia group with 8% ILE or to an inhalation anesthesia group with isoflurane vapor. An up-and-down method and stimulation of tail clamping were used to determine MAC of 8% ILE by intravenous injection in the intravenous anesthesia group and MAC by the inhaled approach in the inhalation anesthesia group, respectively. Isoflurane concentration and partial pressure in end-tidal gas, femoral arterial blood, and jugular venous blood were measured simultaneously just before each tail clamping and during washout.

Results
The induction time in the intravenous anesthesia group (105 +/- 24 s) was shorter than that in the inhalation anesthesia group (378 +/- 102 s; P < 0.01). MAC of 8% ILE by intravenous injection (1.12 +/- 0.18%) was significantly less than MAC by the inhaled approach (1.38 +/- 0.16%; P < 0.05). No significant difference was found between the two groups in the time course of washout of isoflurane.

Conclusion
The MAC of intravenous anesthesia with 8% ILE was less than that of inhalation anesthesia with isoflurane vapor in dogs.
Time Delay of Index Calculation
Authors: Pilge Stefanie , Zanner Robert , Schneider Gerhard , Blum Jasmin , Kreuzer Matthias , Kochs Eberhard F. 
Published: February 2006

Background
On the basis of electroencephalographic analysis, several parameters have been proposed as a measure of the hypnotic component of anesthesia. All currently available indices have different time lags to react to a change in the level of anesthesia. The aim of this study was to determine the latency of three frequently used indices: the Cerebral State Index (Danmeter, Odense, Denmark), the Bispectral Index (Aspect Medical Systems Inc., Newton, MA), and the Narcotrend Index (MonitorTechnik, Bad Bramstedt, Germany).

Methods
Artificially generated signals were used to produce up to 14 constant index values per monitor that indicate "awake state," "general anesthesia," and "deep anesthesia" and smaller steps in between. The authors simulated loss of and return to consciousness by changing between the artificial electroencephalographic signals in a full-step and two stepwise approaches and measured the time necessary to adapt the indices to the particular input signal.

Results
Time delays between 14 and 155 s were found for all indices. These delays were not constant. Results were different for decreasing and increasing values and between the full-step and the stepwise approaches. Calculation time depended on the particular starting and target index value.

Conclusions
The time delays of the tested indices may limit their value in prevention of recall of intraoperative events. Furthermore, different latencies for decreasing and increasing values may indicate a limitation of these monitors for pharmacodynamic studies.
Isoflurane Produces Sustained Cardiac Protection after Ischemia–Reperfusion Injury in Mice
Authors: Tsutsumi Yasuo M. , Patel Hemal H. , Lai N Chin , Takahashi Toshiyuki , Head Brian P. , Roth David M. 
Published: February 2006

Background
Isoflurane reduces myocardial ischemia-reperfusion injury within hours to days of reperfusion. Whether isoflurane produces sustained cardiac protection has never been examined. The authors studied isoflurane-induced cardiac protection in the intact mouse after 2 h and 2 weeks of reperfusion and determined the dependence of this protection on adenosine triphosphate-dependent potassium channels and the relevance of this protection to myocardial function and apoptosis.

Methods
Mice were randomly assigned to receive oxygen or isoflurane for 30 min with 15 min of washout. Some mice received mitochondrial (5-hydroxydecanoic acid) or sarcolemmal (HMR-1098) adenosine triphosphate-dependent potassium channel blockers with or without isoflurane. Mice were then subjected to a 30-min coronary artery occlusion followed by 2 h or 2 weeks of reperfusion. Infarct size was determined at 2 h and 2 weeks of reperfusion. Cardiac function and apoptosis were determined 2 weeks after reperfusion.

Results
Isoflurane did not change hemodynamics. Isoflurane reduced infarct size after reperfusion when compared with the control groups (27.7 +/- 6.3 vs. 41.7 +/- 6.4% at 2 h and 19.6 +/- 5.9 vs. 28.8 +/- 9.0% at 2 weeks). Previous administration of 5-hydroxydecanoic acid, but not HMR-1098, abolished isoflurane-induced cardiac protection. At 2 weeks, left ventricular end-diastolic diameter was decreased significantly and end-systolic pressure and maximum and minimum dP/dt were improved by isoflurane. Isoflurane-treated mice subjected to ischemia and 2 weeks of reperfusion showed less expression of proapoptotic genes, significantly decreased expression of cleaved caspase-3, and significantly decreased deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling-positive nuclei compared with the control group.

Conclusions
Cardiac protection induced by isoflurane against necrotic and apoptotic cell death is associated with an acute memory period that is sustained and functionally relevant 2 weeks after ischemia-reperfusion injury in mice in vivo.
Impact of In Vivo Preconditioning by Isoflurane on Adenosine Triphosphate–sensitive Potassium Channels in the Rat Heart
Authors: Stadnicka Anna , Marinovic Jasna , Bienengraeber Martin , Bosnjak Zeljko J. 
Published: February 2006

Background
The early memory of anesthetic-induced preconditioning (APC) is a period when myocardial protection continues even after removal of the anesthetic. Because adenosine triphosphate-sensitive potassium (KATP) channels are important mediators of APC, the authors investigated the hypothesis that the memory involves channel priming by isoflurane via a long-term modulation of the sensitivity to intracellular adenosine nucleotides.

Methods
Ventricular cardiomyocytes were obtained from the rat hearts after 30 min in vivo APC with 1.4% isoflurane and from control non-APC rat hearts. Whole cell and excised inside-out patch clamp techniques were used to study the sarcolemmal KATP channel. Membrane expression of KATP channel proteins, the pore-forming inward rectifier Kir6.2, and the regulatory sulfonylurea receptor SUR2A were assessed in APC and non-APC hearts by Western blotting.

Results
Activation of whole cell KATP current by isoflurane was enhanced after in vivo APC. At the single-channel level, this was paralleled by a 12-fold decrease in adenosine 5'-triphosphate sensitivity and a 3-fold decrease in adenosine 5'-diphosphate sensitivity, without changing the probability of channel opening or single-channel conductance. The membrane expression of Kir6.2 and SUR2A subunits was not altered by in vivo APC. A direct in vitro application of isoflurane to excised membrane patches increased the channel open probability and produced a 4-fold decrease in adenosine 5'-triphosphate sensitivity only of channels in non-APC myocytes.

Conclusions
In vivo APC by isoflurane decreases sensitivity of the sarcolemmal KATP channel to inhibition by adenosine 5'-triphosphate and decreases adenosine 5'-diphosphate sensitivity. These effects persist even after discontinuation of the anesthetic, suggesting a possible novel factor that may contribute to the mechanism of early memory of APC.
Opioid-induced Hyperalgesia in a Murine Model of Postoperative Pain
Authors: Célérier Evelyne , González Juan R. , Maldonado Rafael , Cabañero David , Puig Margarita M. 
Published: February 2006

Background
Opioid-induced delayed hyperalgesia and allodynia have been reported in human and animal models. The authors evaluated the influence of different opioids used during clinical anesthesia on nociceptive sensitivity and incisional pain in mice. The role of the inducible nitric oxide synthase on surgical pain and opioid-induced pronociception also was investigated.

Methods
CD1 mice were used to study the efficacy of opioids inducing pronociception and enhancing incisional pain. The implication of nitric oxide generated from the inducible nitric oxide synthase was investigated using knockout mice (C57/BL6) for its gene. Mice underwent right hind paw surgery under sevoflurane anesthesia combined with subcutaneous administration of saline or the opioids fentanyl (0.05 mg/kg), alfentanil (1 mg/kg), and remifentanil (0.04 mg/kg). Nociception was evaluated daily for 7 days using paw-pressure, plantar, and von Frey tests.

Results
The antinociceptive effect of opioids was followed by long-lasting thermal hyperalgesia and mechanical allodynia (each lasting between 2 and 7 days), but not mechanical hyperalgesia. Intraoperative infusion of opioids significantly enhanced incisional pain in all tests. The most prominent effects were observed with remifentanil. The inducible nitric oxide synthase gene deletion attenuated both remifentanil- and incision-induced pronociceptive effects. In mutant mice for the inducible nitric oxide synthase gene, remifentanil was still efficient in enhancing incisional pain, but the global pronociceptive effect was attenuated significantly as compared with wild-type mice.

Conclusions
The authors' study demonstrates that the intraoperative administration of fentanyl or remifentanil enhances the extent and duration of postoperative pain. The results suggest a role of the nitric oxide systems in the cause of acute postoperative pain and opioid-induced pronociception.
A comparison of the psychometric properties of three cigarette withdrawal scales
Authors: Etter Jean‐François , Hughes John R. 
Published: February 2006

ABSTRACTAims  To compare the psychometric properties of three cigarette withdrawal scales.Design  An internet cohort study.Participants  Each of 4644 current (44%), former (49%) and never smokers (7%) completed the three scales via the internet. A subsample completed the scales again after 14 days (n = 1309), and indicated their smoking status after 42 days (n = 1431).Measurements  The Cigarette Withdrawal Scale (CWS), the Wisconsin Withdrawal Scale (WWS) and the Minnesota Withdrawal Form (MWF).Findings  All three scales covered the main elements in the Diagnostic and Statistical Manual version IV (DSM‐IV) and the International Classification of Diseases version 10 (ICD‐10) definitions of tobacco withdrawal, but WWS did not cover weight gain. Factor analyses indicated that only six factors were present in WWS, instead of the expected seven factors. Cronbach's alpha coefficients (0.76–0.93) were high for all scales. Test–retest coefficients were in the range of 0.66–0.86 for CWS and WWS, but were somewhat lower for some MWF items (range 0.52–0.80). In 324 ex‐smokers who had quit smoking 31 days or less before baseline, craving predicted relapse at 14‐day follow‐up (CWS: odds ratio = 1.53 per point, P = 0.003; WWS: odds ratio = 1.40, P = 0.04; MWF: odds ratio = 1.49, P = 0.002). In 34 baseline smokers who had quit smoking by 14‐day retest, an increase in craving (WWS and MWF), depressed mood (MWF) and difficulty concentrating (WWS) between baseline and retest predicted relapse at 42‐day follow‐up. In terms of construct validity, scales performed similarly, but performance on some key tests (e.g. withdrawal will increase post‐cessation) were inadequate, due perhaps to methodological limitations.Conclusions  No scale showed a decisive advantage over the others. MWF has the advantage of brevity.
What drug policies cost. Estimating government drug policy expenditures
Authors: Reuter Peter 
Published: February 2006

ABSTRACTAims  Many nations now spend large sums of government money to reduce drug problems. The size and composition of public expenditures aimed at reducing drug use and related problems (a drug budget) is a useful partial description of a nation's drug policy. This paper examines whether it is possible to estimate these sums in a consistent manner across nations.Methods  Past drug budget efforts in the United Kingdom and United States were reviewed. A new methodology was offered for estimation and used for estimates of expenditures in the Netherlands and Sweden. Using this methodology, expenditures were compared. Findings  In both the Netherlands and Sweden, with very different official drug policy rhetoric, enforcement expenditures dominate the total; prevention expenditures are a tiny share. The baseline estimates indicate that the Netherlands, by a variety of metrics (e.g. Euros per capita, Euros per problematic user), spends more on drug control, even enforcement, than Sweden but the range of estimates is such that this cannot be inferred with confidence.Conclusion  Estimating total government expenditures on reducing drug use and related problems is feasible and can yield useful policy insights.
Neurotoxicity of methylenedioxyamphetamines (MDMA; ecstasy) in humans: how strong is the evidence for persistent brain damage?
Authors: Gouzoulis‐Mayfrank E. , Daumann J. 
Published: February 2006

ABSTRACTBackground  The popular dance drug ecstasy (3,4‐methylenedioxymethamphetamine: MDMA and some analogues) causes selective and persistent neurotoxic damage of central serotonergic neurones in laboratory animals. Serotonin plays a role in numerous functional systems in the central nervous system (CNS). Consequently, various abnormalities including psychiatric, vegetative, neuroendocrine and cognitive disorders could be expected in humans following MDMA‐induced neurotoxic brain damage.Aims  In recent years, the question of ecstasy‐induced neurotoxicity and possible functional sequelae has been addressed in several studies with drug users. The aim of this paper was to review this literature and weigh the strength of the evidence for persistent brain damage in ecstasy users.Methods  We used Medline to view all available publications on ‘ecstasy’ or ‘MDMA’. All available studies dealing with ecstasy users entered this analysis.Findings and conclusions  Despite large methodological problems the bulk of evidence suggests residual alterations of serotonergic transmission in MDMA users, although at least partial restitution may occur after long‐term abstinence. However, functional sequelae may persist even after longer periods of abstinence. To date, the most consistent findings associate subtle cognitive, particularly memory, impairments with heavy ecstasy use. However, the evidence cannot be considered definite and the issues of possible pre‐existing traits or the effects of polydrug use are not resolved.Recommendations  Questions about the neurotoxic effects of ecstasy on the brain remain highly topical in light of its popularity among young people. More longitudinal and prospective studies are clearly needed in order to obtain a better understanding of the possible long‐term sequelae of ecstasy use in humans.
Local alcohol prohibition, police presence and serious injury in isolated Alaska Native villages
Authors: Wood Darryl S. , Gruenewald Paul J. 
Published: February 2006

ABSTRACTAims  To consider the effects of alcohol prohibition and police presence upon serious injury in isolated Alaska Native villages.Design  We compared rates of injury attributed to assault, self‐harm, motor vehicle collisions and ‘other causes’ between villages with or without local prohibition and between villages with or without local police. Negative binomial regression was used to assess the relative effects of prohibition and police presence upon serious injury rates net of potential confounders.Participants  A total of 132 isolated Alaska Native villages between the years 1991 through 2000.Measurements  Serious injury was measured using Alaska Trauma Registry and Alaska Bureau of Vital Statistics death certificate records. Local option election records were used to classify cases as occurring in wet or dry villages and police deployment records were used to classify cases as occurring in villages with or without local police. Village‐level statistics from the 1990 and 2000 US censuses were used in the negative binomial regression analyses.Findings  Villages that prohibited alcohol had lower age‐adjusted rates of serious injury resulting from assault, motor vehicle collisions and ‘other causes’. Dry villages with a local police presence had a lower age‐adjusted rate of serious injury caused by assault. Controlling for the relative effects of village isolation, access to alcohol markets and local demographic structures, local prohibition was associated with lower rates of assault injuries and ‘other causes’ injuries while local police presence was associated with lower rates of assault injuries.Conclusions  Residents of isolated Alaska Native villages are safer when they prohibit alcohol. A local police presence in dry villages provides further reduction of the incidence of assault.