The implementation of an early rehabilitation program is associated with reduced length of stay: A multi-ICU study.

Introduction: Survivors of critical illness face many potential long-term sequelae. Prior studies showed that early rehabilitation in the intensive care unit (ICU) reduces physical impairment and decreases ICU and hospital length of stay (LOS). However, these studies are based on a single ICU or were conducted with a small subset of all ICU patients.

dcDegenerate oligonucleotide primed-PCR for multilocus, genome-wide analysis from limited quantities of DNA.

This study modified the degenerate oligonucleotide primed-polymerase chain reaction (DOP-PCR)-based whole genome amplification method for improvement of downstream genome-wide analysis of low copy number DNA samples ( View Article and Find Full Text PDF

Long-term vision results measured with Teller Acuity Cards and a new Light Perception/Projection Scale after management of late stages of retinopathy of prematurity.

Objectives: To report visual acuity (VA) measured by Teller Acuity Cards (TACs) and a new Light Perception/Projection (LPP) Scale in infants with regressed or treated stage 3, 4, or 5 retinopathy of prematurity (ROP), and to compare VA in eyes that underwent successful vitreoretinal surgery for stage 5 ROP with eyes with persistent retinal detachment.

Methods: Nineteen infants (35 eyes) underwent VA testing using TACs and the LPP scale. The correlation between the methods was determined.

Control by tachykinin NK(2) receptors of CRF(1) receptor-mediated activation of hippocampal acetylcholine release in the rat and guinea-pig.

In vivo microdialysis was employed to explore the effects of different selective non-peptides NK(1),NK(2) and NK(3) receptor antagonists on the corticotropin releasing factor (CRF)-induced release of acetylcholine (ACh) in the hippocampus of rats and guinea-pigs. In both species, the intracerebroventricular (i.c.

4-(2-Chloro-4-methoxy-5-methylphenyl)-N-[(1S)-2-cyclopropyl-1-(3-fluoro-4-methylphenyl)ethyl]5-methyl-N-(2-propynyl)-1,3-thiazol-2-amine hydrochloride (SSR125543A): a potent and selective corticotrophin-releasing factor(1) receptor antagonist. I. Biochemical and pharmacological characterization.

4-(2-Chloro-4-methoxy-5-methylphenyl)-N-[(1S)-2-cyclopropyl-1- (3-fluoro-4-methylphenyl)ethyl]5-methyl-N-(2-propynyl)-1,3-thiazol-2-amine hydrochloride (SSR125543A), a new 2-aminothiazole derivative, shows nanomolar affinity for human cloned or native corticotrophin-releasing factor (CRF)(1) receptors (pK(i) values of 8.73 and 9.08, respectively), and a 1000-fold selectivity for CRF(1) versus CRF(2 alpha) receptor and CRF binding protein.

Permissive role of neurokinin NK(3) receptors in NK(1) receptor-mediated activation of the locus coeruleus revealed by SR 142801.

The present experiments investigated the role of neurokinin-1 (NK(1)) and neurokinin-3 (NK(3)) receptors on the activity of the locus coeruleus (LC)-noradrenergic system by using a dual probe microdialysis technique in anesthetized guinea pigs. The local application in the LC of the selective NK(1) receptor agonists [SAR(9),Met(O(2))(11)]-SP (10 microM) and septide (1 microM) as well as the selective NK(3) receptor agonist senktide (1 microM), enhanced the extracellular norepinephrine (NE) levels in the prefrontal cortex. The enhancing effect of [SAR(9),Met(O(2))(11)]-SP was completely blocked by the peripheral administration of the selective non peptide NK(1) and NK(3) receptor antagonists, GR 205171 (1 mg/kg, i.

Expression and presence of septal neurokinin-2 receptors controlling hippocampal acetylcholine release during sensory stimulation in rat.

We examined the expression and presence of NK2 receptors in the septal area of rat brain, and investigated their functional role in the regulation of the septohippocampal cholinergic system. Using reverse transcription-polymerase chain reaction (RT-PCR) analysis, we showed the presence of NK2 receptor mRNA expression in the septal area, and detected septal NK2 binding sites by using a fluorescent-tagged neurokinin A (NKA) derivative. In vivo microdialysis was employed to explore the functional role of NK2 receptors in the release of hippocampal acetylcholine evoked by tactile stimulation in freely moving rats.

Facilitation of striatal acetylcholine release by dopamine D1 receptor stimulation: involvement of enhanced nitric oxide production via neurokinin-2 receptor activation.

The regulation of striatal cholinergic function by dopamine D1 receptor activation was examined in vivo in urethane-anaesthetized rats with microdialysis probes. Extracellular acetylcholine levels were enhanced by activation of D1 receptors either directly by a striatal application of the D1 receptor agonist (+)-SKF-38393 (3 microM) or indirectly by the release of dopamine evoked by striatal application of neurotensin (0.1 microM) under D2 receptor blockade.

Environmental endocrine disruption: an effects assessment and analysis.

This report is an overview of the current state of the science relative to environmental endocrine disruption in humans, laboratory testing, and wildlife species. Background information is presented on the field of endocrinology, the nature of hormones, and potential sites for endocrine disruption, with specific examples of chemicals affecting these sites. An attempt is made to present objectively the issue of endocrine disruption, consider working hypotheses, offer opposing viewpoints, analyze the available information, and provide a reasonable assessment of the problem.

Pharmacological characterization of tachykinin receptors controlling acetylcholine release from rat striatum: an in vivo microdialysis study.

The regulation of striatal cholinergic function by tachykinins was examined in urethane-anesthetized rats by using microdialysis. Substance P (0.01-1 microM), [Sar9, Met (O2)11]substance P (1-10 microM), septide (0.

SR 48692-sensitive neurotensin receptors modulate acetylcholine release in the rat striatum.

The effects of stimulation and blockade of neurotensin receptors on striatal acetylcholine release were examined in anaesthetized rats using microdialysis. Local perfusion with neurotensin (100 nM) did not influence the release of acetylcholine. Application of neurotensin (100 nM) 30 min after haloperidol (125 micrograms/kg, i.

SR 48692, a non-peptide neurotensin receptor antagonist differentially affects neurotensin-induced behaviour and changes in dopaminergic transmission.

Unilateral microinjection of neurotensin in the ventral tegmental area of the rat (2.5 micrograms/0.5 microliter) produced behavioural excitation illustrated by contralateral circling.

[Role of pelvic exenterations in the treatment of cervix cancers. Apropos of 41 surgically treated cases].

The Department of surgical oncology of the Paul-Strauss Cancer Center of Strasbourg (France) reports its experience about pelvic exenterations in recurrent cervix carcinomas. Based on a series of 41 cases (median age: 48.5 years), all patients, but one, have been primarily treated by sole external beam irradiation or surgery combined with radiotherapy.

Influence of mastectomy techniques on estrogen and progesterone receptor analysis in carcinoma of the breast.

Gradual tumor tissue devascularization during mastectomy is thought to decrease estrogen (ER) and progesterone (PgR) receptor activity. To determine whether or not hormone receptor values could be influenced by different mastectomy techniques, 62 patients with carcinoma of the breast had a Tru-cut needle (Baxter Healthcare Corporation) biopsy (premastectomy sample) and underwent modified radical mastectomy (postmastectomy sample) either before (group 1, 40 patients) or after (group 2, 22 patients) axillary lymph node dissection. When the two surgical procedures were compared in 33 patients in whom it could be assessed, no significant tendency (p = 0.

Use of polyglactin 910 mesh (Vicryl) in pelvic oncologic surgery.

Various synthetic materials have been shown to be useful surgical adjuncts in shielding the small intestine from pelvic radiation or in creating a new pelvic floor after major radical resections. Promising preliminary results with a polyglactin 910 (Vicryl) mesh in preventing radiation enteropathy prompted the authors to evaluate its clinical usefulness in reconstruction of the pelvic floor. Use of this mesh in pelvic exenterations (five total, one posterior) for advanced or recurrent gynecologic malignancies was associated with one enteroperineal fistula but no pelvic infection.

[Latissimus dorsi myocutaneous flap closure in mastectomies after chemotherapy of advanced and progressive breast cancers].

A latissimus dorsi myocutaneous flap now appears to be the best solution to closing large carcinological exeresis of the breast. After an analysis of a series of 14 cases of advanced cancer (T3 or T4) or of progressive cancers (PeV3) of the breast treated by inductive chemotherapy and which underwent surgery at the Strasbourg CRLCC (France), the authors stress the simplicity and reliability of the method, which can make it possible to carry out an extensive and complete exeresis, which is of primordial importance in the control of the local tumor. Its excellent trophic quality made it possible to start radiochemotherapeutic adjuvant treatments rapidly.

[Treatment of the pelvis after total pelvic exenteration. Experience of the Regional Paul Strauss Cancer Center of Strasbourg].

Intestinal morbidity after total pelvic exenteration presents usually as fistulae. These appear particularly if irradiation has been carried out in the pelvis or the abdomen before surgery, and particularly as a result of the types of surgery carried out in the emptied pelvis. An analysis of 92 exenterations of the pelvis of which 52 were total exenterations led us to look at how treatments in the pelvis have evolved technically and to analyse the contribution they have made to reducing the number of fistulae and obstructions found as a result of this major surgery.

[Ovarian metastases from colorectal cancers. Current place of prophylactic bilateral ovariectomy].

Ovarian metastases occur in the course of colorectal adenocarcinomas on 3 to 14% of cases. They are bilateral in 50-70% of cases and frequently occult (6 to 25%) and constitute a factor of poor short-term prognosis (median survival: 18 months). After analysing the features of ovarian metastases from colorectal cancers, the authors discuss the current place of prophylactic bilateral oophorectomy in terms of its indications and results.

Prevention of radiation enteritis by an absorbable polyglycolic acid mesh sling. A 60-case multicentric study.

Radiation-induced small bowel injury is a limiting factor to postoperative tumoricidal pelvic doses exceeding 4500 to 5000 cGy. Data from a review of the literature showed the inadequacy of medical measures and the bad reproducibility of radiation therapeutic attempts to decrease small intestine damage. Recent studies cited the benefit of a polyglycolic acid mesh to create an absorbable intestinal sling and suspend the loops above the pelvic radiation field.

[Role of total thyroidectomy in the treatment of multinodular goiter].

Although it may seem to be excessive, total thyroidectomy has recently been advocated by several authors for the treatment of diffuse multiheteronodular goiters. As a complement to a recent study on the thyroid function following thyroidectomy for benign goiters, the authors specify the role of this surgical technique, which had been reserved for the sole thyroid neoplasms for a long time. On the occasion of the presentation of a series of 75 cases gathered from 1989 to 1990, the justification of glandular resection is based on the publication of new pathogenetic data and on the absence of any increase in morbidity, subject to precise indications and to a strict technique aimed at preserving recurrents and locating the parathyroid glands while maintaining their vasculature.

[Surgical removal of diaphragmatic metastasis of advanced ovarian cancer. Review of the literature].

Many studies have established the close relationship between the survival and the residual tumoral volume after a first maximal cyto-reducing surgery. In that light, the surgical exeresis of the metastatic lesions should facilitate the response to chemotherapy. In this respect, the diaphragm metastases of ovarian cancers prove to be worthy of the highest interest due to the difficulty of their surgical approach.

[The value of peritoneal cytology in invasive uterine cancers. Analysis of 80 cases].

When they analysed 80 cancers of the uterus, the authors showed how valuable it was both for diagnosis and prognosis to carry out cytological lavage of the peritoneum, particularly in cases of endometrial adenocarcinoma. The results of this study are compared with recent extracts appearing in the international literature. This technique makes it possible to identify groups of patients of high risk for recurrences in the pelvis and abdomen who would benefit from adjuvant therapies, demonstrating that this technique is applicable to the diagnosis of gynaecological cancers with intraperitoneal spread which have long been failed to be recognised.