Pivotal role of glutathione depletion in plasma-induced endothelial oxidative stress during sepsis.

Objective: Plasma from septic shock patients can induce production of reactive oxygen species (ROS) by human umbilical vein endothelial cells (HUVEC) in vitro. How endothelial cells defend themselves against ROS under increased oxidative stress has not yet been examined. This study investigates the antioxidant defenses of HUVEC exposed to plasma obtained from either septic shock patients or healthy volunteers.

Non-invasive assessment of intracranial pressure using ocular sonography in neurocritical care patients.

Objective: To assess the relationship between optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in neurocritical care patients.

Design: Prospective, observational study.

Setting: Surgical critical care unit, level 1 trauma center.

Ocular sonography in patients with raised intracranial pressure: the papilloedema revisited.

Invasive devices are recommended for the early detection of raised intracranial pressure (ICP) after severe traumatic brain injury. Owing to contraindication or local issues, however, invasive ICP monitoring is not always possible. Moreover, a significant proportion of moderate traumatic brain injury patients (managed without invasive ICP) will develop raised ICP.

[Oral contraception and hormone replacement therapy: management of their thromboembolic risk in the perioperative period].

Objectives: Many women scheduled for surgery are using either oral contraception (OC) or hormone replacement therapy (HRT). These two treatments are associated with a significant albeit moderately increased risk of venous thromboembolic events which might increase the risk associated with surgery.

Data Source: Record of French and English references from Medline((R)) database.

The use of Fresh Frozen Plasma (FFP) in 2007 in France.

After a more than four-fold decrease in Fresh Frozen Plasma (FFP) consumption in the nineties in France, probably due to the consequences of HIV epidemics, the use of FFP is again increasing in recent years but at a slower rate. In the surgical and trauma area, recent data suggest that guidelines for the use of FFP may need to be modified. Indeed, contrary to traditional beliefs and guidelines, several studies evaluating conditions with severe hemorrhage (very often associated with coagulation abnormalities) have shown that early use of FFP may be associated with better patient outcome.

The mu opioid receptor mediates morphine-induced tumor necrosis factor and interleukin-6 inhibition in toll-like receptor 2-stimulated monocytes.

Background: Morphine possesses immunomodulatory effects but its intrinsic mechanisms, especially in the toll-like receptor 2 (TLR2) signaling pathway, are only partially understood. In this study, we evaluated the effects of morphine on tumor necrosis factor (TNF), interleukin-6 (IL-6), and interleukin-10 (IL-10) production in TLR2-stimulated human monocytes and identified the involvement of the different opioid receptors, and of the lymphocyte-to-monocyte contact.

Methods: Peripheral blood mononuclear cells (PBMCs) were isolated from fresh blood by centrifugation on a density gradient.

The limited efficacy of tramadol in postoperative patients: a study of ED80 using the continual reassessment method.

Background: The aim of this study was to reevaluate the efficacy of tramadol for postoperative analgesia and to determine its ED80 (the clinical dose for which 80% of the patients had their pain adequately relieved) using the Continual Reassessment Method. Because the preliminary results of the first 24 patients were contradictory to the literature, we performed a second trial to verify and validate our data.

Methods: The study was double-blind and prospective.

[Coma with bilateral mydriasis after use of transdermal scopolamine in ICU].

We report the case of an ICU patient with previous medical history of head trauma with hydrocephalus requiring ventricular derivation, presenting a coma (Glasgow Coma Score=8) with bilateral mydriasis after the use of transdermal scopolamine (1 mg) for profuse bronchial secretions. Neurological explorations (CT-scan and electroencephalogram) confirmed the absence of organic cause to the neurological deterioration. Neurological status rapidly and completely improved after removal of transdermal scopolamine suggesting a central anticholinergic syndrome.

Posttraumatic brain vulnerability to hypoxia-hypotension: the importance of the delay between brain trauma and secondary insult.

Objective: To examine whether the effect of hypoxia-hypotension (HH) after traumatic brain injury (TBI) is affected by the delay between insults.

Design: Thirty Sprague-Dawley rats were randomized into five groups: sham, TBI alone (trauma alone, impact-acceleration, 450 g weight drop from 1.8 m), HH alone (blood depletion, mean arterial pressure 40 mmHg, FIO2=10%, 15 min), TBI+early HH (TBI followed by HH, 45-min delay), and TBI+late HH (225-min delay).

Induced mild hypothermia reduces mortality during acute inflammation in rats.

Background: Hypothermia has been proposed as a therapeutic possibility in brain trauma, cardiac arrest and hemorrhagic shock. Experimental studies have shown that hypothermia may act by modulating the inflammatory response during endotoxemia. This study was carried out to test whether hypothermia could protect rats from endotoxemic insult.

Postoperative Analgesic THerapy Observational Survey (PATHOS): a practice pattern study in 7 central/southern European countries.

Surveys evaluating pain in hospitals keep on showing that postoperative pain (POP) remains undertreated. At the time when guidelines are edited and organisational changes are implemented, more recent data are necessary to check the impact of these measures on daily practice and needs for improvement. This prospective, cross-sectional, observational, multi-centre practice survey was performed in 2004-2005 in 7 European countries.

Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury.

Objective: To assess at admission to the ICU the relationship between optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) and to investigate whether increased ONSD at patient admission is associated with raised ICP in the first 48[Symbol: see text]h after trauma.

Design And Setting: Prospective, blind, observational study in a surgical critical care unit, level 1 trauma center.

Patients And Participants: 31 adult patients with severe traumatic brain injury (TBI; Glasgow coma scale View Article and Find Full Text PDF

Cardiac troponin I release after hip surgery correlates with poor long-term cardiac outcome.

Background And Objective: The aim of this study was to assess the incidence of perioperative myocardial damage detected by serial measurements of troponin I after hip surgery and its association with late cardiovascular outcome.

Methods: Troponin I was measured during the first three postoperative days in 88 consecutive patients undergoing hip surgery. Values above the 99th percentile (0.