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[PMID]: 28658200 [Au] Autor: Messner F; Hautz T; Blumer MJF; Bitsche M; Pechriggl EJ; Hermann M; Zelger B; Zelger B; Öfner D; Schneeberger S [Ad] Endereço: 1 Center for Operative Medicine, Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria. 2 Department of Anatomy, Histology and Embryology, Division of Clinical and Functional Anatomy, Medical University Innsbruck, Innsbruck, Austria. 3 Department of Anesthesiology and Critical Care Medicine, Medical University Innsbruck, Innsbruck, Austria. 4 Department of Pathology, Medical University Innsbruck, Innsbruck, Austria. 5 Department of Dermatology, Medical University Innsbruck, Innsbruck, Austria. [Ti] Título: Critical Ischemia Times and the Effect of Novel Preservation Solutions HTK-N and TiProtec on Tissues of a Vascularized Tissue Isograft. [So] Source: Transplantation;101(9):e301-e310, 2017 Sep. [Is] ISSN: 1534-6080 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: We herein investigate critical ischemia times and the effect of novel preservation solutions such as new histidine-tryptophan-ketoglutarate (HTK-N) and TiProtec on the individual tissues of a rat limb isograft. METHODS: Orthotopic hind-limb transplantations were performed in male Lewis rats after 2 hours, 6 hours, or 10 hours of cold ischemia (CI). Limbs were flushed and stored in HTK-N, TiProtec, HTK, or saline solution. Muscle, nerve, vessel, skin, and bone samples were procured on day 10 for histology, immunohistochemistry, confocal and electron microscopy, and quantitative real-time polymerase chain reaction analysis. RESULTS: Histomorphology of the muscle showed a mainly perivascular inflammatory infiltrate, fibrotic degeneration, and neovascularization after 6 hours and 10 hours of CI. However, centrally aligned nuclei observed in muscle fibers suggest for muscle regeneration in these samples. In addition to Wallerian degeneration, nerve injury was significantly aggravated (P = 0.032) after prolonged CI. Proinflammatory and regulatory cytokines were most significantly upregulated after 2-hour CI. Our data suggest no superiority of novel perfusates HTK-N and TiProtec in terms of tissue preservation, compared with HTK and saline. CONCLUSIONS: Limiting CI time for less than 6 hours is the most significant factor to reduce tissue damage in vascularized tissue transplantation. Signs of muscle regeneration give rise that ischemic muscle damage in limb transplantation might be reversible to a certain extent. [Mh] Termos MeSH primário: Transplante Ósseo/efeitos adversos Isquemia Fria/efeitos adversos Membro Posterior/irrigação sanguínea Membro Posterior/transplante Soluções para Preservação de Órgãos/farmacologia Preservação de Órgãos/métodos Transplante de Pele/efeitos adversos [Mh] Termos MeSH secundário: Animais Transplante Ósseo/métodos Citoproteção Regulação da Expressão Gênica Glucose/farmacologia Membro Posterior/metabolismo Membro Posterior/ultraestrutura Isoenxertos Masculino Manitol/farmacologia Microscopia Confocal Microscopia Eletrônica de Transmissão Modelos Animais Desenvolvimento Muscular/efeitos dos fármacos Cloreto de Potássio/farmacologia Procaína/farmacologia Ratos Endogâmicos Lew Reação em Cadeia da Polimerase em Tempo Real Regeneração/efeitos dos fármacos Transplante de Pele/métodos Fatores de Tempo Sobrevivência de Tecidos/efeitos dos fármacos Degeneração Walleriana [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Bretschneider cardioplegic solution); 0 (HTK-N solution); 0 (Organ Preservation Solutions); 0 (TiProtec solution); 3OWL53L36A (Mannitol); 4Z8Y51M438 (Procaine); 660YQ98I10 (Potassium Chloride); IY9XDZ35W2 (Glucose) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171010 [Lr] Data última revisão: 171010 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170629 [St] Status: MEDLINE [do] DOI: 10.1097/TP.0000000000001845

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[PMID]: 28403128 [Au] Autor: Compagnon P; Levesque E; Hentati H; Disabato M; Calderaro J; Feray C; Corlu A; Cohen JL; Ben Mosbah I; Azoulay D [Ad] Endereço: 1 Service de Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est, Créteil, France. 2 Institut Mondor Recherche Biomédicale (IMRB), Université Paris-Est, Créteil, France. 3 Service de Réanimation Digestive, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est, Créteil, France. 4 Service d'Anatomopathologie, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est, Créteil, France. 5 Service d'Hépatologie, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est, Créteil, France. 6 INSERM, Univ Rennes, INRA, Nutrition Metabolisms and Cancer (NuMeCan), Rennes, France. 7 Biopredic International, Rennes, France. [Ti] Título: An Oxygenated and Transportable Machine Perfusion System Fully Rescues Liver Grafts Exposed to Lethal Ischemic Damage in a Pig Model of DCD Liver Transplantation. [So] Source: Transplantation;101(7):e205-e213, 2017 Jul. [Is] ISSN: 1534-6080 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Control of warm ischemia (WI) lesions that occur with donation after circulatory death (DCD) would significantly increase the donor pool for liver transplantation. We aimed to determine whether a novel, oxygenated and hypothermic machine perfusion device (HMP Airdrive system) improves the quality of livers derived from DCDs using a large animal model. METHODS: Cardiac arrest was induced in female large white pigs by intravenous injection of potassium chloride. After 60 minutes of WI, livers were flushed in situ with histidine-tryptophan-ketoglutarate and subsequently preserved either by simple cold storage (WI-SCS group) or HMP (WI-HMP group) using Belzer-MPS solution. Liver grafts procured from heart-beating donors and preserved by SCS served as controls. After 4 hours of preservation, all livers were transplanted. RESULTS: All recipients in WI-SCS group died within 6 hours after transplantation. In contrast, the HMP device fully protected the liver against lethal ischemia/reperfusion injury, allowing 100% survival rate. A postreperfusion syndrome was observed in all animals of the WI-SCS group but none of the control or WI-HMP groups. After reperfusion, HMP-preserved livers functioned better and showed less hepatocellular and endothelial cell injury, in agreement with better-preserved liver histology relative to WI-SCS group. In addition to improved energy metabolism, this protective effect was associated with an attenuation of inflammatory response, oxidative load, endoplasmic reticulum stress, mitochondrial damage, and apoptosis. CONCLUSIONS: This study demonstrates for the first time the efficacy of the HMP Airdrive system to protect liver grafts from lethal ischemic damage before transplantation in a clinically relevant DCD model. [Mh] Termos MeSH primário: Hepatectomia Transplante de Fígado/instrumentação Fígado/cirurgia Perfusão/instrumentação Traumatismo por Reperfusão/prevenção & controle Isquemia Quente/instrumentação [Mh] Termos MeSH secundário: Aloenxertos Animais Biomarcadores/metabolismo Modelos Animais de Doenças Metabolismo Energético Desenho de Equipamento Feminino Glucose/farmacologia Sobrevivência de Enxerto Parada Cardíaca/induzido quimicamente Hepatectomia/efeitos adversos Fígado/metabolismo Fígado/patologia Testes de Função Hepática Transplante de Fígado/efeitos adversos Transplante de Fígado/métodos Manitol/farmacologia Teste de Materiais Soluções para Preservação de Órgãos/farmacologia Perfusão/efeitos adversos Perfusão/métodos Cloreto de Potássio/farmacologia Procaína/farmacologia Traumatismo por Reperfusão/etiologia Traumatismo por Reperfusão/metabolismo Traumatismo por Reperfusão/patologia Sus scrofa Fatores de Tempo Sobrevivência de Tecidos Isquemia Quente/efeitos adversos Isquemia Quente/métodos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Biomarkers); 0 (Bretschneider cardioplegic solution); 0 (Organ Preservation Solutions); 3OWL53L36A (Mannitol); 4Z8Y51M438 (Procaine); 660YQ98I10 (Potassium Chloride); IY9XDZ35W2 (Glucose) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170912 [Lr] Data última revisão: 170912 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170414 [St] Status: MEDLINE [do] DOI: 10.1097/TP.0000000000001764

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[PMID]: 28327076 [Au] Autor: De Palo M; Guida P; Mastro F; Nanna D; Quagliara TA; Rociola R; Lionetti G; Paparella D [Ad] Endereço: Department of Emergency and Organ Transplant, Division of Cardiac Surgery, University of Bari Aldo Moro, Bari, Italy. [Ti] Título: Myocardial protection during minimally invasive cardiac surgery through right mini-thoracotomy. [So] Source: Perfusion;32(3):245-252, 2017 Apr. [Is] ISSN: 1477-111X [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Myocardial damage is an independent predictor of adverse outcome following cardiac surgery and myocardial protection is one of the key factors to achieve successful outcomes. Cardioplegia with Custodiol is currently the most used cardioplegia during minimally invasive cardiac surgery (MICS). Different randomized controlled trials compared blood and Custodiol cardioplegia in the context of traditional cardiac surgery. No data are available for MICS. AIM: The aim of this study was to compare the efficacy of cold blood versus Custodiol cardioplegia during MICS. METHOD: We retrospectively evaluated 90 patients undergoing MICS through a right mini-thoracotomy in a three-year period. Myocardial protection was performed using cold blood (44 patients, CBC group) or Custodiol (46 patients, Custodiol group) cardioplegia, based on surgeon preference and complexity of surgery. RESULTS: The primary outcomes were post-operative cardiac troponin I (cTnI) and creatine kinase MB (CKMB) serum release and the incidence of Low Cardiac Output Syndrome (LCOS). Aortic cross-clamp and cardiopulmonary bypass times were higher in the Custodiol group. No difference was observed in myocardial injury enzyme release (peak cTnI value was 18±46 ng/ml in CBC and 21±37 ng/ml in Custodiol; p=0.245). No differences were observed for mortality, LCOS, atrial or ventricular arrhythmias onset, transfusions, mechanical ventilation time duration, intensive care unit and total hospital stay. CONCLUSIONS: Custodiol and cold blood cardioplegic solutions seem to assure similar myocardial protection in patients undergoing cardiac surgery through a right mini-thoracotomy approach. [Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/métodos Soluções Cardioplégicas/uso terapêutico Parada Cardíaca Induzida/métodos Coração/fisiopatologia Procedimentos Cirúrgicos Minimamente Invasivos/métodos Toracotomia/métodos [Mh] Termos MeSH secundário: Adulto Idoso Arritmias Cardíacas/sangue Arritmias Cardíacas/etiologia Arritmias Cardíacas/fisiopatologia Arritmias Cardíacas/prevenção & controle Transfusão de Sangue/métodos Baixo Débito Cardíaco/sangue Baixo Débito Cardíaco/etiologia Baixo Débito Cardíaco/fisiopatologia Baixo Débito Cardíaco/prevenção & controle Procedimentos Cirúrgicos Cardíacos/efeitos adversos Creatina Quinase Forma MB/sangue Feminino Glucose/uso terapêutico Coração/efeitos dos fármacos Coração/fisiologia Seres Humanos Masculino Manitol/uso terapêutico Meia-Idade Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos Cloreto de Potássio/uso terapêutico Procaína/uso terapêutico Estudos Retrospectivos Toracotomia/efeitos adversos Troponina I/sangue [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Bretschneider cardioplegic solution); 0 (Cardioplegic Solutions); 0 (Troponin I); 3OWL53L36A (Mannitol); 4Z8Y51M438 (Procaine); 660YQ98I10 (Potassium Chloride); EC 2.7.3.2 (Creatine Kinase, MB Form); IY9XDZ35W2 (Glucose) [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170509 [Lr] Data última revisão: 170509 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170323 [St] Status: MEDLINE [do] DOI: 10.1177/0267659116679249

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[PMID]: 28285862 [Au] Autor: Dalvandi A; Ranjbar H; Hatamizadeh M; Rahgoi A; Bernstein C [Ad] Endereço: University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Electronic address: dalvandi@uswr.ac.ir. [Ti] Título: Comparing the effectiveness of vapocoolant spray and lidocaine/procaine cream in reducing pain of intravenous cannulation: A randomized clinical trial. [So] Source: Am J Emerg Med;35(8):1064-1068, 2017 Aug. [Is] ISSN: 1532-8171 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: INTRODUCTION: Venous cannulation is the most common procedure in emergency departments. The aim of this study was to compare the effectiveness of vapocoolant spray and EMLA cream in reduction of pain during venous cannulation in 6-12years old children. METHODS: The study was a randomized clinical trial with a crossover design. It took place between June and December 2015 at Ali-Asghar hospital in Tehran, Iran. 40 Thalassemic children who need regular blood transfusions were randomly assigned in two groups. The pain of intravenous cannulation was measured using a visual analogue scale for pain (VAS-P). With the crossover design each patient received vapocoolant spray and EMLA cream in the next two visits. The patients were allocated into two groups (A and B). The patients in Group (A) received Vapocoolant spray in the first visit and EMLA cream in the second visit before intravenous cannulation. The patients in Group (B) group were exposed to the opposite order. RESULTS: The pain after Vapocoolant spray was 3.22±1.18 which was significantly lower than control (7.12±1.36) and higher than EMLA cream (0.77±1.09), p>0.001. The anxiety before cannulation had a significant effects on the reported pain by children. The ANCOVA showed that despite the effects of anxiety the results did not change significantly. CONCLUSION: The results indicated that vapocoolant spray was not as effective as EMLA cream, in the event of an emergency and in patients with allergic reactions to lidocaine and procaine ingredients Vapocoolant is an efficacious alternative. [Mh] Termos MeSH primário: Anestésicos Locais/uso terapêutico Cateterismo Periférico/efeitos adversos Serviço Hospitalar de Emergência Lidocaína/uso terapêutico Dor/prevenção & controle Procaína/uso terapêutico [Mh] Termos MeSH secundário: Administração Tópica Aerossóis Ansiedade Cateterismo Periférico/métodos Criança Estudos Cross-Over Feminino Seres Humanos Irã (Geográfico) Masculino Pomadas Medição da Dor Resultado do Tratamento [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Aerosols); 0 (Anesthetics, Local); 0 (Ointments); 4Z8Y51M438 (Procaine); 98PI200987 (Lidocaine) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171020 [Lr] Data última revisão: 171020 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170314 [St] Status: MEDLINE

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[PMID]: 28237801 [Au] Autor: Zakowski W; Braszka L; Zawistowski P; Orzel-Gryglewska J; Jurkowlaniec E [Ad] Endereço: Department of Animal and Human Physiology, Faculty of Biology, University of Gdansk, Wita Stwosza 59, 80-308 Gdansk, Poland. Electronic address: witold.zakowski@biol.ug.edu.pl. [Ti] Título: Inactivation of the medial mammillary nucleus attenuates theta rhythm activity in the hippocampus in urethane-anesthetized rats. [So] Source: Neurosci Lett;645:19-24, 2017 04 03. [Is] ISSN: 1872-7972 [Cp] País de publicação: Ireland [La] Idioma: eng [Ab] Resumo: Although the importance of the mammillary body for memory and learning processes is well known, its exact role has remained vague. The fact, that many neurons in one nucleus of the mammillary body in rats, i.e. the medial mammillary nucleus (MM), fires according with hippocampal theta rhythm, makes this structure crucial for a theta rhythm signaling in so-called extended hippocampal system. These neurons are driven by descending projections from the hippocampal formation, but it is still unknown whether the mammillary body only conveys theta rhythm or may also modulate it. In the present study, we investigated the effect of pharmacological inactivation (local infusion of 0.5µl of 20% procaine hydrochloride solution) of the MM on hippocampal theta rhythm in urethane-anesthetized rats. We found that intra-MM procaine microinjections suppress sensory-elicited theta rhythm in the hippocampus by reduction of its amplitude, but not the frequency. Procaine infusion decreased the EEG signal power of low theta frequency bands, i.e. 3-5Hz, down to 9.2% in 3-4Hz band in comparison to pre-injection conditions. After water infusion (control group) no changes of hippocampal EEG signal power were observed. Our findings showed for the first time that inactivation of the MM leads to a disruption of hippocampal theta rhythm in the rat, which may suggest that the mammillary body can regulate theta rhythm signaling in the extended hippocampal system. [Mh] Termos MeSH primário: Anestésicos Intravenosos Hipotálamo Posterior/fisiopatologia Ritmo Teta Uretana [Mh] Termos MeSH secundário: Anestésicos Locais/farmacologia Animais Masculino Corpos Mamilares/fisiopatologia Microinjeções Procaína/farmacologia Ratos Wistar [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Anesthetics, Intravenous); 0 (Anesthetics, Local); 3IN71E75Z5 (Urethane); 4Z8Y51M438 (Procaine) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171101 [Lr] Data última revisão: 171101 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170227 [St] Status: MEDLINE

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[PMID]: 28189913 [Au] Autor: Linnekamp JF; Butter R; Spijker R; Medema JP; van Laarhoven HW [Ad] Endereço: Laboratory of Experimental Oncology and Radiobiology (LEXOR), Center for Experimental Molecular Medicine (CEMM), Academic Medical Center (AMC), University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Cancer Center Amsterdam and Cancer Genomics Center, Amsterdam, The Netherlands. [Ti] Título: Clinical and biological effects of demethylating agents on solid tumours - A systematic review. [So] Source: Cancer Treat Rev;54:10-23, 2017 Mar. [Is] ISSN: 1532-1967 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: BACKGROUND: It is assumed that DNA methylation plays a key role in both tumour development and therapy resistance. Demethylating agents have been shown to be effective in the treatment of haematological malignancies. Based on encouraging preclinical results, demethylating agents may also be effective in solid tumours. This systematic review summarizes the evidence of the effect of demethylating agents on clinical response, methylation and the immune system in solid tumours. METHODS: We conducted a systematic literature search from 1949 to December 2016, according to the PRISMA guidelines. Studies which evaluated treatment with azacitidine, decitabine, guadecitabine, hydralazine, procaine, MG98 and/or zebularine in patients with solid tumours were included. Data on clinical response, effects on methylation and immune response were extracted. RESULTS: Fifty-eight studies were included: in 13 studies complete responses (CR) were observed, 35 studies showed partial responses (PR), 47 studies stable disease (SD) and all studies except two showed progressive disease (PD). Effects on global methylation were observed in 11/15 studies and demethylation/re-expression of tumour specific genes was seen in 15/17 studies. No clear correlation between (de)methylation and clinical response was observed. In 14 studies immune-related responses were reported, such as re-expression of cancer-testis antigens and upregulation of interferon genes. CONCLUSION: Demethylating agents are able to improve clinical outcome and alter methylation status in patients with solid tumours. Although beneficial effect has been shown in individual patients, overall response is limited. Further research on biomarker predicting therapy efficacy is indicated, particularly in earlier stage and highly methylated tumours. [Mh] Termos MeSH primário: Antimetabólitos Antineoplásicos/uso terapêutico Neoplasias/tratamento farmacológico [Mh] Termos MeSH secundário: Azacitidina/análogos & derivados Azacitidina/uso terapêutico Citidina/análogos & derivados Citidina/uso terapêutico Metilação de DNA/efeitos dos fármacos Seres Humanos Hidralazina/uso terapêutico Sistema Imunitário/efeitos dos fármacos Metilação/efeitos dos fármacos Neoplasias/imunologia Neoplasias/metabolismo Neoplasias/radioterapia Procaína/uso terapêutico Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Nm] Nome de substância: 0 (Antimetabolites, Antineoplastic); 26NAK24LS8 (Hydralazine); 2KT4YN1DP7 (guadecitabine); 4Z8Y51M438 (Procaine); 5CSZ8459RP (Cytidine); 776B62CQ27 (decitabine); 7A9Y5SX0GY (pyrimidin-2-one beta-ribofuranoside); M801H13NRU (Azacitidine) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 171116 [Lr] Data última revisão: 171116 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170213 [St] Status: MEDLINE

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[PMID]: 27892594 [Au] Autor: Gebhardt V; Mueller-Hansen L; Schwarz A; Bussen D; Weiss C; Schmittner MD [Ad] Endereço: Department of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Centre Mannheim, Mannheim, Germany. [Ti] Título: Chloroprocaine 10 mg/ml for low-dose spinal anaesthesia in perianal surgery - a randomised dose finding study. [So] Source: Acta Anaesthesiol Scand;61(2):241-249, 2017 Feb. [Is] ISSN: 1399-6576 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Low-dose spinal anaesthesia is a safe and reliable anaesthesia technique in outpatient perianal surgery. Regarding its short duration of action and its trend to hyperbaric characteristics, plain chloroprocaine 10 mg/ml seems to be ideal to perform low-dose spinal anaesthesia. The aim of this trial was to determine the optimal dosage of chloroprocaine for this indication. METHODS: Hundred and twenty patients undergoing perianal surgery were enrolled and randomly allocated to receive 10, 20 or 30 mg of chloroprocaine 10 mg/ml intrathecally. Patients had to sit upright for at least 10 min after injection. We measured the expansion of sensory and motor block and the times until voiding, walking without assistance and home discharge. RESULTS: The expansion of the sensory (P ≤ 0.0059) and the motor block (P ≤ 0.0086) gained with increasing doses. At a dose of 30 mg the incidence of a profound, clinically relevant motor block was significantly higher compared to 10 and 20 mg (P ≤ 0.0004). In the 10 mg group two patients suffered from nociceptive pain due to an incomplete block and five patients announced discomfort during procedure. Doses of 10 and 20 mg led to a significantly earlier discharge compared to 30 mg (P = 0.0003; P = 0.0406). CONCLUSION: Plain chloroprocaine 10 mg/ml can successfully be used for low-dose spinal anaesthesia in perianal outpatient surgery. Regarding the unfavourable motor block and later discharge-times in the 30 mg group on the one hand and the block-failures in the 10 mg group on the other, 20 mg can be recommended as the optimal dose. [Mh] Termos MeSH primário: Canal Anal/cirurgia Raquianestesia/métodos Anestésicos Locais/farmacologia Procaína/análogos & derivados [Mh] Termos MeSH secundário: Adulto Feminino Seres Humanos Masculino Meia-Idade Procaína/farmacologia [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Anesthetics, Local); 4Z8Y51M438 (Procaine); 5YVB0POT2H (chloroprocaine) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161129 [St] Status: MEDLINE [do] DOI: 10.1111/aas.12839

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[PMID]: 27878830 [Au] Autor: Wang ZH; An Y; Du MC; Qin TJ; Liu YB; Xu HZ; Yang LQ [Ad] Endereço: Department of Cardiac Surgery, People's Hospital of Dongyang, Dongyang. [Ti] Título: Clinical Assessment of Histidine-Tryptophan-Ketoglutarate Solution and Modified St. Thomas' Solution in Pediatric Cardiac Surgery of Tetralogy of Fallot. [So] Source: Artif Organs;41(5):470-475, 2017 May. [Is] ISSN: 1525-1594 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: The objective of this study is to compare the myocardium protective effect of Bretschneider's histidine-tryptophan-ketoglutarate (HTK) solution versus Modified St. Thomas' (STH) solution in pediatric cardiac surgery of Tetralogy of Fallot (TOF). Seventy-seven pediatric patients of TOF who received the total surgical repair were reviewed, from January 2014 to October 2015. A horizontal comparison between HTK solution and modified STH solution has been made since the HTK solutions were started to be used in our hospital. The patients were divided into the HTK group (n = 35) and the STH group (n = 33). The perioperative values of the groups were assessed in this study. The primary endpoints including spontaneous cardiac re-beating time, intensive care unit (ICU) stay, overall stay, mechanical ventilation postoperation, postoperation stay, overall stay, and perioperative echocardiographic results were analyzed in this study. We found that spontaneous cardiac re-beating time of the HTK group was significantly shorter than that of the STH group (0.26 min ± 0.56 vs. 1.33 ± 1.02, P < 0.001). There were no significant differences between the two groups in ICU stay (P = 0.29), postoperative mechanical ventilation time (P = 0.84), overall stay (0.73); and the mortalities of the two groups were similar (2.9 vs. 3.0%). Aimed at pediatric cardiac surgery of TOF, this study suggests that with similar aorta cross-clamping time, modified STH solution is as safe as HTK solution. [Mh] Termos MeSH primário: Soluções Cardioplégicas/uso terapêutico Coração/efeitos dos fármacos Tetralogia de Fallot/cirurgia [Mh] Termos MeSH secundário: Adolescente Adulto Bicarbonatos/uso terapêutico Cloreto de Cálcio/uso terapêutico Criança Pré-Escolar Feminino Glucose/uso terapêutico Parada Cardíaca Induzida/métodos Seres Humanos Lactente Magnésio/uso terapêutico Masculino Manitol/uso terapêutico Contração Miocárdica/efeitos dos fármacos Cloreto de Potássio/uso terapêutico Procaína/uso terapêutico Cloreto de Sódio/uso terapêutico Adulto Jovem [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Bicarbonates); 0 (Bretschneider cardioplegic solution); 0 (Cardioplegic Solutions); 0 (St. Thomas' Hospital cardioplegic solution); 3OWL53L36A (Mannitol); 451W47IQ8X (Sodium Chloride); 4Z8Y51M438 (Procaine); 660YQ98I10 (Potassium Chloride); I38ZP9992A (Magnesium); IY9XDZ35W2 (Glucose); M4I0D6VV5M (Calcium Chloride) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171016 [Lr] Data última revisão: 171016 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161124 [St] Status: MEDLINE [do] DOI: 10.1111/aor.12771

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[PMID]: 27873010 [Au] Autor: Mueller CM; Sinclair TJ; Stevens M; Esquivel M; Gordon N [Ad] Endereço: Division of Pediatric Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Alway Building M116, MC: 5733, Stanford, CA, 94305, USA. clmueller@lpch.org. [Ti] Título: Regional block via continuous caudal infusion as sole anesthetic for inguinal hernia repair in conscious neonates. [So] Source: Pediatr Surg Int;33(3):341-345, 2017 Mar. [Is] ISSN: 1437-9813 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: PURPOSE: The use of general anesthesia in young children has come under increasing scrutiny due to its potential long-term neurotoxic effects. Meanwhile, regional anesthesia for surgical procedures in neonates has many advantages, including preservation of respiratory status and faster return to feeding. We describe the successful use of 3% 2-chloroprocaine administered via continuous caudal infusion as the sole anesthetic agent during elective surgical procedures in infants. METHODS: A retrospective chart review of all patients who underwent elective surgical procedures under continuous caudal regional anesthetic at a single institution was performed. Thirty patients (27 males, three females) were identified: 28 patients underwent inguinal hernia repairs. Caudal anesthesia was established via continuous infusion of 3% 2-chloroprocaine through an indwelling catheter. RESULTS: Successful analgesia by regional block alone was achieved in all patients for the duration of each surgical procedure without need for rescue anesthesia. Mean operative time was 49 min. Patients were able to return to feeding immediately after surgery and were ready for discharge home within that day. CONCLUSION: Continuous caudal infusion of chloroprocaine is a safe and effective way to maintain adequate analgesia for elective surgeries in infants. This successful regional approach obviates the use of general anesthetic which reduces post-operative recovery time and avoids concerns for neurotoxicity. [Mh] Termos MeSH primário: Anestesia por Condução/métodos Hérnia Inguinal/cirurgia Procaína/análogos & derivados [Mh] Termos MeSH secundário: Anestesia Caudal/métodos Anestésicos Locais/administração & dosagem Feminino Seres Humanos Recém-Nascido Infusões Intravenosas Masculino Procaína/administração & dosagem Estudos Retrospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Anesthetics, Local); 4Z8Y51M438 (Procaine); 5YVB0POT2H (chloroprocaine) [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170926 [Lr] Data última revisão: 170926 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161123 [St] Status: MEDLINE [do] DOI: 10.1007/s00383-016-4027-6

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MEDLINE

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[PMID]: 27557558 [Au] Autor: Jalili S; Saeedi M [Ad] Endereço: Department of Chemistry, K. N. Toosi University of Technology, Tehran, P.O. Box 15875-4416, Iran. sjalili@kntu.ac.ir. [Ti] Título: Study of procaine and tetracaine in the lipid bilayer using molecular dynamics simulation. [So] Source: Eur Biophys J;46(3):265-282, 2017 Apr. [Is] ISSN: 1432-1017 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Despite available experimental results, the molecular mechanism of action of local anesthetics upon the nervous system and contribution of the cell membrane to the process are still controversial. In this work, molecular dynamics simulations were performed to investigate the effect of two clinically used local anesthetics, procaine and tetracaine, on the structure and dynamics of a fully hydrated dimyristoylphosphatidylcholine lipid bilayer. We focused on comparing the main effects of uncharged and charged drugs on various properties of the lipid membrane: mass density distribution, diffusion coefficient, order parameter, radial distribution function, hydrogen bonding, electrostatic potential, headgroup angle, and water dipole orientation. To compare the diffusive nature of anesthetic through the lipid membrane quantitatively, we investigated the hexadecane/water partition coefficient using expanded ensemble simulation. We predicted the permeability coefficient of anesthetics in the following order: uncharged tetracaine > uncharged procaine > charged tetracaine > charged procaine. We also shown that the charged forms of drugs are more potent in hydrogen bonding, disturbing the lipid headgroups, changing the orientation of water dipoles, and increasing the headgroup electrostatic potential more than uncharged drugs, while the uncharged drugs make the lipid diffusion faster and increase the tail order parameter. The results of these simulation studies suggest that the different forms of anesthetics induce different structural modifications in the lipid bilayer, which provides new insights into their molecular mechanism. [Mh] Termos MeSH primário: Anestésicos Locais/metabolismo Anestésicos Locais/farmacologia Bicamadas Lipídicas/metabolismo Procaína/metabolismo Procaína/farmacologia Tetracaína/metabolismo Tetracaína/farmacologia [Mh] Termos MeSH secundário: Anestésicos Locais/química Membrana Celular/química Membrana Celular/efeitos dos fármacos Membrana Celular/metabolismo Difusão Dimiristoilfosfatidilcolina/metabolismo Bicamadas Lipídicas/química Conformação Molecular Simulação de Dinâmica Molecular Procaína/química Tetracaína/química Termodinâmica [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Anesthetics, Local); 0 (Lipid Bilayers); 0619F35CGV (Tetracaine); 4Z8Y51M438 (Procaine); U86ZGC74V5 (Dimyristoylphosphatidylcholine) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170922 [Lr] Data última revisão: 170922 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160826 [St] Status: MEDLINE [do] DOI: 10.1007/s00249-016-1164-8

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