The objective of this study was to evaluate whether major abdominal surgery leads to complement activation and interleukin response and whether the kind of anaesthesia influence complement activation ...and the release of inflammatory interleukins. The study design was prospective and randomised. Fifty patients undergoing open major colorectal surgery due to cancer disease or inflammatory bowel disease were studied. Twenty‐five patients were given total intravenous anaesthesia (TIVA) with propofol and remifentanil, and 25 patients were given inhalational anaesthesia with sevoflurane and fentanyl. To determine complement activation (C3a and SC5b‐9) and the release of pro‐ and anti‐inflammatory interleukins (tumour necrosis factor‐a (TNF‐a)), interleukin‐1b (IL‐1b), IL‐6, IL‐8, IL‐4 and IL‐10), blood samples were drawn preoperatively, 60 minutes after start of surgery, 30 minutes after end of surgery and 24 hours postoperatively. Complement was activated and pro‐inflammatory interleukins (IL‐6 and IL‐8) and anti‐inflammatory interleukins (IL‐10) were released during major colorectal surgery. There was no significant difference between TIVA and inhalational anaesthesia regarding complement activation and cytokine release. Major colorectal surgery leads to activation of the complement cascade and the release of both pro‐inflammatory and anti‐inflammatory cytokines. There are no significant differences between total intravenous anaesthesia (TIVA) with propofol and remifentanil and inhalational anaesthesia with sevoflurane and fentanyl regarding complement activation and the release of pro‐ and anti‐inflammatory interleukins.
Abstract Objective To examine baseline characteristics and biochemically verified 1-, 4-, and 6-month tobacco quit rates among college students enrolled in a Quit and Win cessation trial, comparing ...those who concurrently smoke both hookah and cigarettes with those who deny hookah use. Methods Analyses were conducted on data from 1217 college students enrolled in a Quit and Win tobacco cessation randomized clinical trial from 2010–2012. Multivariable logistic regression (MLR) analyses examined group differences in baseline characteristics and cotinine verified 30-day abstinence at 1, 4, and 6-month follow-up, adjusting for baseline covariates. Results Participants smoked 11.5(± 8.1) cigarettes per day on 28.5(± 3.8) days/month, and 22% smoked hookah in the past 30 days. Hookah smokers (n = 270) were more likely to be male (p < 0.0001), younger (p < 0.0001), report more binge drinking (p < 0.0001) and score higher on impulsivity (p < 0.001). MLR results indicate that hookah users, when compared to non-users, had a 36% decrease in odds of self-reported 30-day abstinence at 4-months (OR = 0.64, 95% CI = 0.45–0.93, p = 0.02) and a 63% decrease in odds in biochemically verified continuous abstinence at 6-months (OR = 0.37, CI = 0.14–0.99, p = 0.05). Conclusion College cigarette smokers who concurrently use hookah display several health risk factors and demonstrate lower short and long-term tobacco abstinence rates.
The development of models of marine ecosystems in the Southern Ocean is becoming increasingly important as a means of understanding and managing impacts such as exploitation and climate change. ...Collating data from disparate sources, and understanding biases or uncertainties inherent in those data, are important first steps for improving ecosystem models. This review focuses on seals that breed in ice habitats of the Southern Ocean (i.e. crabeater seal, Lobodon carcinophaga; Ross seal, Ommatophoca rossii; leopard seal, Hydrurga leptonyx; and Weddell seal, Leptonychotes weddellii). Data on populations (abundance and trends in abundance), distribution and habitat use (movement, key habitat and environmental features) and foraging (diet) are summarised, and potential biases and uncertainties inherent in those data are identified and discussed. Spatial and temporal gaps in knowledge of the populations, habitats and diet of each species are also identified.
Several formulas have been proposed to adjust the QT interval for heart rate, the most commonly used being the QT correction formula (QTc = QT/square root of RR) proposed in 1920 by Bazett. The QTc ...formula was derived from observations in only 39 young subjects. Recently, the adequacy of Bazett's formula has been questioned. To evaluate the heart rate QT association, the QT interval was measured on the initial baseline electrocardiogram of 5,018 subjects (2,239 men and 2,779 women) from the Framingham Heart Study with a mean age of 44 years (range 28 to 62). Persons with coronary artery disease were excluded. A linear regression model was developed for correcting QT according to RR cycle length. The large sample allowed for subdivision of the population into sex-specific deciles of RR intervals and for comparison of QT, Bazett's QTc and linear corrected QT (QTLC). The mean RR interval was 0.81 second (range 0.5 to 1.47) heart rate 74 beats/min (range 41 to 120), and mean QT was 0.35 second (range 0.24 to 0.49) in men and 0.36 second (range 0.26 to 0.48) in women. The linear regression model yielded a correction formula (for a reference RR interval of 1 second): QTLC = QT + 0.154 (1-RR) that applies for men and women. This equation corrects QT more reliably than the Bazett's formula, which overcorrects the QT interval at fast heart rates and undercorrects it at low heart rates. Lower and upper limits of normal QT values in relation to RR were generated.
Anesthesia during surgery often induces an inflammatory response. The aim of this study was to establish and compare differences in inflammatory response among colorectal cancer surgery patients ...receiving either total intravenous anesthesia (TIVA) with propofol and remifentanil or inhalational anesthesia (INHAL) with sevoflurane and fentanyl.
After randomization, we included fifty consecutive patients undergoing colorectal cancer surgery in our study. TIVA patients received total intravenous anesthesia with propofol and remifentanil, while INHAL patients received inhalation anesthesia with sevoflurane in O2/air and fentanyl. Plasma concentrations of IL-8, IL-17, MPO, ICAM-1, V-CAM and L-selectin were quantified. Blood loss, body temperature and blood glucose levels were measured in patients both before and after surgery.
In both groups, levels of IL-8, MPO, ICAM-1 and L-selectin decreased 60 min after the start of surgery (P<0.05, P<0.01, respectively) and 30 min post-surgery (P<0.05 for both groups). In the INHAL group, V-CAM levels were significantly lower 60 min after the start of surgery (P<0.01) and 30 min post-surgery (P<0.05). At 24 h post-surgery, V-CAM levels were significantly higher in both groups (P<0.01), while IL-17 levels significantly increased only in the INHAL group (P<0.05). Higher blood glucose levels were also observed in the INHAL group compared to that in the TIVA group (P<0.01).
TIVA with propofol and remifentanil and INHAL with sevoflurane and fentanyl induced similar inflammatory responses during colorectal cancer surgery. We found that IL-17 cytokine levels were higher in patients anesthetized with sevoflurane and fentanyl.
Abstract
Background
This is a description of consecutive patients converted from ileal pouch-anal anastomosis (IPAA) to continent ileostomy (CI) at a tertiary centre, outcome after surgery and ...patient satisfaction after long time follow-up.
Methods
All consecutive patients operated with IPAA which later was converted to a CI at Sahlgrenska University Hospital, Gothenburg, Sweden, were included in the study. Demographic data was registered and a questionnaire regarding quality of life was sent to included patients.
Results
A total of 28 patients were included during the period of 1985-2022. The most common diagnosis was Ulcerative Colitis (UC) (n=23), other diagnoses included Crohn′s disease (n=2) and Familial Adenomatous Polyposis (n=1) (missing data n=2). IPAA was performed at a mean age of 30 (15-49) years and IPAA converted to CI at a mean age of 39 (22-62) years. At follow-up, three of the patients were diseased, not related to conversion surgery, and one had moved abroad. All of the remaining 24 patients completed the questionnaire. 20/28 (71%) patients still had their CI in function. 17/28 (61%) were converted due to fistula problems and the rest due to functional problems. 20/28 (71%) were converted using their IPAA-pouch and 4/28 (14%) had a new-constructed reservoir (missing data n=4). Totally, 18/20 (90% p<0.001) were satisfied with the CI and 19/20 (95% p<0.001) would choose it again if they were facing the same situation, even if most of the patients needed revision of the reservoir (mean 2 (0-5) surgeries). Four patients required excision of the CI. All excised patients had UC and was converted using their original IPAA. The main reason for conversion in the excised group was fistula with the inner meatus in the IPAA (three woman with anovaginal fistula and one man with perianal fistula).
Conclusion
A CI is an alternative that patients seem to be satisfied with, even after long follow-up time, when IPAA is no longer a suitable alternative. The majority of the patients in this study were converted from IPAA to CI using their IPAA-pouch.
A few members of the bacterial genus
Thermus
have been shown to be incomplete denitrifiers, terminating with nitrite (NO
2
−
) or nitrous oxide (N
2
O). However, the denitrification abilities of the ...genus as a whole remain poorly characterized. Here, we describe diverse denitrification phenotypes and genotypes of a collection of 24 strains representing ten species, all isolated from a variety of geothermal systems in China. Confirmed terminal products of nitrate reduction were nitrite or N
2
O, while nitric oxide (NO) was inferred as the terminal product in some strains. Most strains produced N
2
O; complete denitrification was not observed. Denitrification phenotypes were largely consistent with the presence of denitrification genes, and strains of the same species often had the same denitrification phenotypes and largely syntenous denitrification gene clusters. Genes for
nirS
and
nirK
coexisted in three
Thermus brockianus
and three
Thermus oshimai
genomes, which is a unique hallmark of some denitrifying
Thermus
strains and may be ecologically important. These results show that incomplete denitrification phenotypes are prominent, but variable, within and between
Thermus
species. The incomplete denitrification phenotypes described here suggest
Thermus
species may play important roles in consortial denitrification in high-temperature terrestrial biotopes where sufficient supply of oxidized inorganic nitrogen exists.
DESPITE the large number of diagnostic and prognostic tests that can be used to evaluate patients with suspected coronary artery disease, the treadmill exercise test remains the most readily ...available and the most often used for this purpose, especially by noncardiologists. Previous studies have identified the major prognostic variables related to this test among patients undergoing either invasive
1
2
3
4
5
or noninvasive
6
,
7
evaluation. After identifying the important prognostic variables, we devised a simple prognostic treadmill score, using data on a population of inpatients referred to our institution for cardiac catheterization between 1969 and 1980.
4
This treadmill score, which was validated in a . . .
Background: The use of recombinant human erythropoietin (rHuEPO) improves autologous blood donation before elective surgery. However, there are other studies indicating that rHuEPO may suppress ...postoperative endogenous production of erythropoietin and stimulate inflammatory mediator release. Weekly donations generate only a moderate increase in endogenous erythropoietin production. We scheduled patients with cancer to predeposit three units of blood in 2 weeks, with or without rHuEPO therapy. The aim was to determine whether rHuEPO therapy and/or an aggressive donation schedule alter perioperative erythropoietin concentrations and whether rHuEPO therapy leads to the release of the pro‐inflammatory cytokines IL‐6 and IL‐8.
Methods: Thirty women scheduled for radical hysterectomy and pelvic lymphadenectomy were randomly assigned to either a control group with no rHuEPO therapy or to receive rHuEPO. Three units of whole blood were collected from each patient before the operation. Concentrations of haemoglobin, erythropoietin (s‐EPO) and cytokines (IL‐6 and IL‐8) were repeatedly analyzed before and after the operation.
Results: During the preoperative donation period, median s‐EPO levels in the control group increased from 7 to 14 IU l−1. There was a great increase in s‐EPO concentrations 1 h postoperatively in the rHuEPO group compared with the control group (P < 0.001). IL‐6 and IL‐8 were not significantly changed after intravenous administration of rHuEPO.
Conclusion: The use of rHuEPO therapy to optimise autologous blood donation does not influence IL‐6 and IL‐8 release. 1 h postoperatively rHuEPO therapy resulted in elevated s‐EPO concentrations. There was, however, no difference in s‐EPO between the groups from day 1 postoperatively and until the end of the study.
During a series of transect legs through the pack ice of the eastern Ross Sea, aboard the RV icebreaker ‘Nathaniel B. Palmer’, we: (1) assessed the habitat chosen for moulting by emperor ...penguins,Aptenodytes forsteri, (2) determined their pre- and post-moult diets, (3) measured the pre- and post-moult body mass of the birds, and (4) tracked their post-moult movements. Diet was based on the colour of guano near the edges of ice floes and fast-ice areas. Pre- and post-moult birds were weighed at locations along the transect. Satellite transmitters were attached to 7 birds, and tracked for up to 5 mo. Birds moulted in concentrated pack ice and coastal fast ice. Offshore from the shelf slope, diet was mostly Antarctic krillEuphausia superba. Over the shelf, the diet was mainly fish and squid. Body masses of birds immediately after the moult were often less than 20 kg. After moult, satellite tracked birds remained in the pack ice but moved to the west at a rate of 13 to 41 km d–1. One bird traveled to the Cape Roget colony, where it arrived on 15 April after 70 d and 2140 km of travel. We conclude that (1) birds are close to starvation by the end of the moult, (2) it is essential that an abundant food supply is in close proximity to the moult area, (3) penguins travel more than 2000 km on the return journey to their colonies of the western Ross Sea, and (4) reduction in the extent and seasonal duration of the pack ice would be reflected in a rapid change in the size of the breeding population of coastal west Antarctica.
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