Effects of acidosis on the structure, composition, and function of adult murine femurs.

Physiologic pH is maintained in a narrow range through multiple systemic buffering systems. Metabolic Acidosis (MA) is an acid-base disorder clinically characterized by a decrease in systemic pH and bicarbonate (HCO) levels. Acidosis affects millions annually, resulting in decreased bone mineral density and bone volume and an increased rate of fracture.

Sex-Specific Gene Expression in the Mouse Nucleus Accumbens Before and After Cocaine Exposure.

The nucleus accumbens plays a major role in the response of mammals to cocaine. In animal models and human studies, the addictive effects of cocaine and relapse probability have been shown to be greater in females. Sex-specific differential expression of key transcripts at baseline and after prolonged withdrawal could underlie these differences.

Effects of methylene blue and volatile anesthetics on survival in a murine hemorrhage resuscitation model.

Background: Hemorrhage is a frequent cause of morbidity and mortality, possibly complicated by volatile anesthetics administered during surgical emergencies. Because methylene blue (MB) was suggested to reduce bleeding, we reasoned that it may improve resuscitation. We used a rat model of controlled and uncontrolled hemorrhage with fluid resuscitation, aiming at high versus low mean arterial pressure (MAP) to assess the role of early MB injection on survival and the effects of different anesthetics on outcome.

Intrasplenic preconditioning: a model for the study of xenostimuli accommodation.

Background: Discordant xenotransplantation, the grafting of organs from one phylogenic species to another, results in hyper-acute rejection (HAR). HAR is associated with the deposition of recipient preformed xenoreactive natural antibodies and complement on the endothelium of the donor organ, leading to activation and apoptosis of the endothelium, an event associated with xenograft rejection. Endothelial resistance to HAR, termed "accommodation," an active protection of graft endothelium, may be achieved by previous stimulation of endothelial cells by discordant xenoantibodies.

Topical ophthalmic amethocaine alleviates trigeminal neuralgia pain.

Background: Trigeminal neuralgia (TGN) is a challenging pain syndrome.

Aim: To test the effectiveness of local instillation of ophthalmic solution of amethocaine in relieving the pain of TGN.

Methods: We performed an open-label prospective study in 40 consecutive currently treated patients suffering from TGN with a reported visual analog scale (VAS) >8 (severe pain).

CobraPLA Insertion by anesthetists and non-anesthetists wearing unconventional protective gear: a prospective study in humans.

Background: The threat of a mass casualty unconventional attack has challenged the medical community to devise means for providing rapid and reliable emergent airway control under chaotic conditions by inexperienced medical personnel dressed in self protective gear. Since endotracheal intubation may not be feasible under those conditions, other extraglottic devices should be considered. We assessed the performance of anesthesia and non-anesthesia residents in inserting the CobraPLA, a supraglottic airway device, on consecutive anesthetized patients, to assess its potential use under simulated conditions.

Supraglottic devices: a possible role in prehospital toxic mass casualty event?

Rapidly progressive respiratory failure is the leading cause of death from inhalation of toxic chemical warfare agents. In an expected chaotic scenario, direct laryngoscopic tracheal intubation is unlikely to be easily and quickly performed due to shortage of medical personnel experienced with laryngoscopy and/or reduced dexterity imposed by the protective gear worn by the caregivers. Supraglottic devices have increasingly been used for emergent airway control in prehospital settings, thus avoiding the need for laryngoscopy.

Effect of small bowel perforation during laparoscopy on end-tidal carbon dioxide: observation in a small animal model.

Introduction: There are currently no reports in the literature regarding changes in end-tidal carbon dioxide (ETCO(2)) when the small bowel is deliberately or inadvertently perforated during laparoscopic surgery. The aim of this study was to assess the influence of small bowel perforation during laparoscopy on ETCO(2) in a rat model.

Materials And Methods: Two groups of Wistar rats (n = 8/group) were anesthetized, tracheostomized, and mechanically ventilated at a fixed tidal volume and respiratory rate.

ACC/AHA guidelines for preoperative cardiovascular evaluation for noncardiac surgery: a critical point of view.

This review examines the issue of preoperative cardiac evaluation from a critical point of view, based on recent medical literature. We reviewed the history of that field and focused on the American College of Cardiology and American Heart Association guidelines, which are a cornerstone in the field of cardiac patients undergoing noncardiac surgery. These guidelines synthesized the data into a comprehensive format and established the concept of integrating the patient's risk with the surgical risk.

Single-dose ketamine administration induces apoptosis in neonatal mouse brain.

Unlabelled: The activity of N-methyl-D-aspartate (NMDA) receptors is critical for neuronal survival in the immature brain. Studies have reported that chronic blockage of these receptors mediates apoptosis in neonatal animals. We investigated the apoptotic effect of a clinically relevant single dose of ketamine, an NMDA receptor antagonist, in the brain of neonatal mice.

Interaction between thiopental and fentanyl in mice is different between hypnotic and lethal doses.

Much is known about the interaction of intravenous anesthetics and opioids at the therapeutic level, but less is known regarding their combined lethal effect, leaving some uncertainty regarding the window of safety for their clinical use. We set out to document the type of interaction between thiopental and fentanyl for both the hypnotic effect (loss of righting reflex) and lethal effect in mice. Hypnotic and lethal dose-response curves were constructed for thiopenthal alone and in combination with fentanyl (0.

Atropine aborts bradycardic effect of endotracheally administered vasopressin.

Background: Vasopressin is an alternative drug to adrenaline in intractable ventricular fibrillation. However, vasopressin can cause significant bradycardia, resulting in reduced cardiac output. We investigated whether pre-treatment with atropine abrogates vasopressin-induced bradycardia in a beating-heart canine model.

Cerebroventricular injection of clonidine causes analgesia mediated by a nitrogen pathway.

Whereas neuroaxially administered clonidine produces analgesia partially mediated by alpha2-adrenoceptor-induced augmented synthesis of nitric oxide (NO), the central mechanisms by which clonidine produces its antinociceptive effects are still speculative. We used the tail-flick model of acute pain in mice to further explore the role of NO in mediating clonidine-induced central analgesia. Cerebroventricular administration of the following agents was studied: clonidine, L-arginine (NO precursor), the NO production inhibitor nitro-L-arginine-methyl ester (L-NAME), the NO antagonist methylene blue (MB), and nitroglycerine (NO-releasing agent).

Involvement of nitric oxide in clonidine-induced spinal analgesia.

Background: The chronic pain relieving effects following spinal administration of clonidine are probably connected to alpha2-adrenoreceptor-induced augmented synthesis of nitric oxide (NO) in the spinal cord. In contrast, when acute pain is considered, the possible role of NO is still speculative. The aim of the present study was to explore the role of NO in acute pain relief following intraspinal administration of clonidine.

Beta1- or beta2-blockers to improve hemodynamics following endotracheal adrenaline administration.

Background: The recommended dose for endotracheal adrenaline (0.02 mg/kg) causes a pronounced initial decrease in diastolic blood pressure which is detrimental at the initial phase of cardiopulmonary resuscitation. This effect was previously attributed to an early and preferential stimulation of the beta-adrenergic receptors causing vasodilatation unopposed by an alpha-adrenergic vasoconstriction.

Biphasic extrathoracic cuirass ventilation for resuscitation.

Purposes: The MRTX portable lightweight respirator (MRTX) provides noninvasive respiratory support using biphasic extrathoracic ventilation via a cuirass fitted around the patient's chest.

Methods: MRTX was applied with or without full protective gear, on adult volunteers simulating nerve agent (NA) victims by nonmedical caregivers. Assessment was made based on scores for correct positioning of the cuirass, quality of seal, and rapidness.

Application of a cuirass and institution of biphasic extra-thoracic ventilation by gear-protected physicians.

Objectives: To evaluate the speed by which cuirass application, followed by biphasic extra-thoracic ventilation, can be instituted by full anti-chemical protective gear-wearing physicians.

Materials And Methods: Ten physicians of variable subspecialties applied a cuirass on an adult volunteer and instituted biphasic extra-thoracic ventilation, using the RTX respirator (Medivent, London, UK). Endotracheal (ET) intubation and manual ventilation of a mannequin and its ventilation was comparatively assessed.

Attenuation of liver ischemia-reperfusion-induced atrial dysfunction by external pacing but not by isoproterenol.

Remote ischemia-reperfusion detrimentally affects myocardial function by initially interfering with the rate of contraction. We investigated the usefulness of isoproterenol versus external electrical pacing in attenuating secondary functional damage of isolated Wistar rat atria. Atrial strips (n = 10/group) were bathed within oxygenated Krebs-Henseleit solution that exited from isolated livers that had been either perfused normally (controls) or underwent no flow (ischemia) for 2 h.

Laryngeal mask airway insertion by anesthetists and nonanesthetists wearing unconventional protective gear: a prospective, randomized, crossover study in humans.

Background: Mass casualty situations impose special difficulties in airway management, even for experienced caregivers. The laryngeal mask airway is part of the difficult airway algorithm. The authors evaluated the success rate and the time to secure airways by mask by anesthetists, surgeons, and novices when wearing either surgical attire or full antichemical protective gear that included butyl rubber gloves and a filtering antigas mask.

Antichemical protective gear prolongs time to successful airway management: a randomized, crossover study in humans.

Background: Airway management is the first step in resuscitation. The extraordinary conditions in mass casualty situations impose special difficulties in airway management, even for experienced caregivers. The authors evaluated whether wearing surgical attire or antichemical protective gear made any difference in anesthetists' success of airway control with either an endotracheal tube or a laryngeal mask airway.

Laryngeal mask airway control versus endotracheal intubation by medical personnel wearing protective gear.

The purpose of this study was to evaluate the rates of successful airway control using endotracheal tubes (ETs) or laryngeal mask airways (LMAs) and compare them between anesthetists and non-anesthetists wearing full antichemical protective gear. Anesthetists and non-anesthetists (n = 10 per group) twice attempted inserting ETs and LMAs on a mannequin model of airway management in a crossover, prospective manner. Times to successful insertion and failure rates were recorded.

'Ecstasy' intoxication: life-threatening manifestations and resuscitative measures in the intensive care setting.

Objective: The ingestion of 3,4-methylenedioxymethamphetamine ('ecstasy') can cause severe neurological impairment and multi-system damage. We describe the potentially life-threatening clinical features and the management of intoxication by this psychedelic drug in patients transferred from emergency services to the intensive care area.

Methods: We conducted a retrospective analysis of 'ecstasy'-intoxicated patients admitted to a municipal hospital during a three-month period.

Intraosseous emergency access by physicians wearing full protective gear.

Objectives: To assess prospectively and randomly the feasibility, speed, and success rate of establishing an intraosseous access using the Bone Injection Gun (BIG) while wearing antichemical outfits.

Methods: Attempts to introduce intraosseous injection with or without a full protective gear (antichemical body suit, face mask, and butyl gloves) were performed using a turkey bone model. Time to proper placement was measured.

Tracheal epinephrine or norepinephrine preceded by beta blockade in a dog model. Can beta blockade bestow any benefits?

Tracheal epinephrine (adrenaline) has been associated with two major deletorious side effects: increased heart rate (HR) and an initial decrease of blood pressure (BP). This prospective randomized animal study compared the haemodynamic responses to tracheally administered epinephrine or norepinephrine (nor adrenaline) alone versus each after pretreatment with propranolol for ameliorating those two untoward effects associated with epinephrine administration. Five anaesthetized mongrel dogs underwent 25 experiments of tracheal epinephrine or norepinephrine (0.