Twenty-five fit patients undergoing third molar surgery received the non-steroidal anti-inflammatory drug tenoxicam 40 mg given orally the night before surgery or intravenously at the time of surgery ...in a randomised, double-blind, cross-over trial. Propofol was used for intravenous sedation. Pain on injection was noted with propofol in 32-56 percent of subjects, but was mostly of minor nature. There was high (100 percent) acceptance of the method of sedation, with 60-84 percent rate of amnesia. Experience of post-operative pain, intake of medication, and trismus were similar with both methods of administration of tenoxicam. We conclude that both oral and intravenous administration of 40 mg tenoxicam are equally effective in healthy young patients undergoing third molar surgery.
A cluster analysis was performed using the following parameters: blood eosinophil level, total serum IgE, number of aeroallergen sensitivities (skin prick testing or serum ImmunoCAP to 18 relevant ...aeroallergens), spirometry, daily inhaled corticosteroid (ICS) dose, number of controller medications, age, BMI, and gender.
Methods After IRB approval, saliva was collected from asthmatics (n=26) and miRNAs were isolated by guanidium hydrochloride/phenol-chloroform extraction, reversed transcribed using a poly-A, ...3'adapter system, and analyzed by quantitative real-time PCR.
Background Increasing the number of arterial grafts for coronary artery bypass grafting (CABG) has been linked to improved late survival. Currently, it is not known if these long-term benefits are ...also true when sequential radial artery (RA) grafts are the primary means to maximizing arterial revascularization. Methods We compared late survival of 532 consecutive patients receiving sequential RA grafts (sequential RA group: 438 men; 462 with three-vessel disease) with that of a 4,131 contemporaneous internal thoracic artery (ITA) with saphenous vein (SV) multivessel CABG cohort (conventional group). Graft failure rates were determined from symptom-driven repeat angiography films in 122 sequential RA patients performed 2 to 4,317 days after surgery. Median survival sequential RA follow-up was 5.3 years (range, 0.5 to 12.3). Results The sequential RA patients received a total of 1,181 RA grafts (538 sequential 30 triple and 75 single) along with 636 SV and 533 ITA. Overall RA graft failure (80 of 272; 29%) was intermediate to that for ITA (7 of 121; 5.8%; p < 0.001) and vein (54 of 133, 41.6%; p = 0.032) grafts. Sequential versus nonsequential RA failure did not differ (77 of 252 31% versus 3 of 20 15%; p = 0.202), while failure of the proximal (36 of 123; 29%) and distal (40 of 129; 31%) components of sequential RA grafts were essentially identical. A total of 69 deaths (6 operative; 1.1%) have occurred in the sequential RA cohort. Unadjusted 10-year sequential RA cohort survival was 76.2% overall, and 79.0% for the 454 primary isolated CABG subgroup. The risk-adjusted 10-year survival using a logit propensity score was substantially better for the sequential RA cohort versus the conventional CABG cohort (risk ratio 95% confidence interval 0.61 0.44 to 0.85; p = 0.003). Conclusions Sequential RA grafting is a safe method for maximizing arterial revascularization and is associated with excellent 10-year survival that seems to be superior to conventional or ITA/SV CABG results. Also, the similar proximal and distal sequential RA patency mitigates concerns of a clinically significant effect of increased vasoreactivity of distal segments of RA conduits.
Transcription of ribosomal RNAs in Escherichia coli is started from two strong tandem promoters, P1 and P2. It is known, however, that internal promoter-like structures occur and in a recent report ...(Mankin et al., 1987) a promoter sequence Pi within the 16S and 23S RNA spacer region showing good homology to the prokaryotic consensus promoter structure was identified. It was proposed that this putative promoter has a possible function in the transcription of ribosomal RNAs in E. coli. Fusion of various DNA fragments containing the putative promoter sequence and different parts of the 16S/23S spacer region as well as the 23S RNA to the galactokinase gene allowed us to assess the functional activity of the promoter in vivo. To determine any growth rate dependent function of the putative promoter, the measurements were performed under different growth conditions. The promoter activity did not exceed 7% of the lac promoter under in vivo assay conditions. In addition, transcription starting at the promoter Pi did not proceed through the entire 23S RNA gene. We conclude, therefore, that transcription from Pi does not contribute significantly to the synthesis of ribosomal RNAs. Thus its functional significance, if any, remains elusive.
Background We have demonstrated previously that valproic acid (VPA), a histone deacetylase inhibitor, can improve survival in lethal models of hemorrhagic shock. This study investigated whether VPA ...treatment would improve survival in a clinically relevant large animal model of poly-trauma/hemorrhagic shock, and whether the protective effects are executed through the Akt survival pathway. Methods Yorkshire swine were subjected to a poly-trauma protocol including: (1) Pre-hospital phase- Femur fracture, 60% hemorrhage, 30 min of shock (mean arterial pressure MAP: 25-30 mmHg), and infusion of 154mM NaCl (3 × shed blood); (2) Early hospital phase A Grade V liver injury (simulating rupture of a previously contained hematoma) followed by liver packing; (3) Treatment/monitoring phase randomization to 3 treatment groups ( n = 6–8/group): no treatment (control), fresh whole blood (FWB), and intravenous VPA (400 mg/kg, given during the pre-hospital phase). Animals were monitored for 4 h, with survival being the primary endpoint. Liver tissue was subjected to Western blot analysis. Results FWB ( n = 6) and VPA treatments ( n = 7) significantly increased survival (100% and 86%, respectively) compared to control group ( n = 8) (25%). The protocol produced significant anemia (Hb<6 g/dL) and lactic acidosis (lactate 3–5 mmol/L). Acidosis improved after blood transfusion and worsened in the other two groups. VPA treatment increased phospho-Akt (activated), phospho-GSK-3β (Glycogen synthase kinase 3β), β-catenin and Bcl-2 (B-cell leukemia/lymphoma 2) protein levels compared to control group ( P = .01, .01, .03, and .02, respectively). There was no significant difference in the level of these proteins between the control and FWB groups. Conclusion Treatment with VPA without blood transfusion improves early survival in a highly lethal poly-trauma and hemorrhagic shock model. The survival advantage is due not to improvement in resuscitation but to better tolerance of shock by the cells, in part due to the preservation of the Akt survival pathway.
Exercise is a classic trigger of ventricular arrhythmias in the setting of coronary artery disease (CAD). The aim of this study was to examine the changes of novel indexes of repolarization in ...patients with stable CAD who underwent exercise stress testing. Sixty-seven consecutive patients (mean age 62 ± 9 years, 60 men) who underwent treadmill exercise stress testing according to the Bruce protocol and completed the test without evidence of ischemia were enrolled. Baseline clinical and demographic characteristics were recorded, and indexes of repolarization such as corrected QT (QTc) interval, T peak-to-end (Tpe) interval, and Tpe/QT ratio were assessed at baseline and at peak exercise. A similar group of control subjects without CAD (n = 68, mean age 60 ± 11 years, 52 men) were also studied. All participants successfully completed the test. In the patient group, the QTc interval significantly increased from baseline to peak exercise (median 385 ms 25th percentile 357 ms, 75th percentile 407 ms vs 418 ms 381 ms, 447 ms, p <0.001). The Tpe interval and the Tpe/QT ratio were also significantly increased at peak exercise (42 ms 36 ms, 60 ms vs 78 ms 60 ms, 84 ms, p <0.001; and 0.17 0.14, 0.22 vs 0.21 0.16, 0.25, p = 0.015). In the control group, the QTc interval did not change significantly, the Tpe interval decreased at peak exercise (62 ms 41 ms, 80 ms vs 48 ms 40 ms, 78 ms, p = 0.05), and the Tpe/QT ratio did not show a significant change (0.18 0.12, 0.22 vs 0.16 1.14, 0.21, p = 0.39). In patients with stable CAD and normal treadmill exercise stress test results, the QTc interval, the Tpe interval, and the Tpe/QT ratio increased during exercise. In conclusion, it is reasonable to assume that despite the absence of inducible ischemia, the spatial dispersion of repolarization is increased during exercise, exposing these patients to increased arrhythmic risk.
Morphine sulphate was used for the control of pain following major abdominal surgery for a period of three days either as patient-controlled or continuous infusion. The two groups of patients were ...comparable with regard to patient and operation details, duration of infusion, pain scores and complications. The only significant difference was a reduced dose requirement of morphine in the patient-controlled analgesia group (P less than 0.005). Some possible explanations for this finding are given. It is suggested that a properly supervised continuous infusion of morphine is as good as patient-controlled administration. There was a negative correlation between the age of the patient and the dose of morphine used.
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