scholarly journals Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yitzhak Brzezinski-Sinai ◽  
Ester Zwang ◽  
Elena Plotnikova ◽  
Ester Halizov ◽  
Itzhak Shapira ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
General Anesthesia ◽  
Vascular Disease ◽  
Cholinesterase Activity ◽  
Serum Cholinesterase ◽  
Hemodynamic Support ◽  
System A ◽  
Lower Baseline ◽  
Increased Risk ◽  
A Prospective Study

AbstractMaintaining hemodynamic stability during the induction and maintenance of anesthesia is one of the challenges of the anesthesiologist. Patients with vascular disease are at increased risk of instability due to imbalance between the sympathetic and parasympathetic parts of the autonomic nervous system, a balance accessible by serum cholinesterase activity. We aim to characterize the dynamics of cholinesterase activity in patients undergoing general anesthesia (GA) and surgery. This was a prospective study of 57 patients undergoing ambulatory or vascular surgery under GA. Cholinesterase activity was measured before the induction of anesthesia, after 15 min and at the end of surgery by calculating the capacity of serum acetylcholinesterase (AChE) and butyrylcholinesterase to hydrolyze AcetylThioCholine. Data on atherosclerotic disease, anesthesia management were analyzed. Both AChE and total cholinergic status (CS) decreased significantly after GA induction at 15 min and even more so by the end of surgery. Vascular surgery patients had lower baseline cholinesterase activity compared to ambulatory surgery patients. Patients requiring intraoperative administration of phenylephrine for hemodynamic support (21.1%) had a significantly lower level of AChE and CS compared to untreated patients. Our findings serve as a mirror to the sympathetic/parasympathetic imbalance during GA, with a marked decrease in the parasympathetic tone. The data of a subgroup analysis show a correlation between low cholinesterase activity and an increase in the need for hemodynamic support.

Cholinesterase activity in serum during general anesthesia in health and disease

2021 ◽  
Author(s):  
Yitzhak Brzezinski Sinai ◽  
Ester Zwang ◽  
Elena Plotnikova ◽  
Esti Halizov ◽  
Itzhak Shapira ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
General Anesthesia ◽  
Cholinesterase Activity ◽  
Marked Decrease ◽  
Serum Cholinesterase ◽  
Activity Increase ◽  
Hemodynamic Support ◽  
Lower Baseline ◽  
Health And Disease ◽  
Baseline Values

Abstract Atherosclerotic patients challenge the anesthesiologist as they display a significant instability between the two parts of the autonomic nervous system. We aimed to assess the effect of general anesthesia (GA) and surgery on serum cholinesterase activity. Prospective study of 57 patients undergoing ambulatory or vascular surgery under GA. Cholinesterase levels were measured before induction of anesthesia, 15 minutes thereafter and at the end of surgery by measuring the capacity of serum Acetylcholinesterase (AChE) and Butyrylcholinesterase to hydrolyze AcetylThioCholine. Data of atherosclerotic disease, anesthesia management were analyzed.Both AChE and total Cholinergic Status (CS) decreased significantly after GA induction at 15 minutes and furthermore by the end of surgery. Vascular surgery patients, presented lower baseline cholinesterase activity compared to patients for ambulatory surgery. In patients requiring intraoperative administration of phenylephrine for hemodynamic support (21.1%), a significant lower level of AChE and CS was observed compared to untreated patients. A positive correlation was found between the lowest temperatures measured and the AChE and CS change from the baseline values. Our findings serve as a mirror to the sympathetic/parasympathetic disbalance during GA with a marked decrease in the parasympathetic tone. Our data show that low cholinesterase activity increase the need for hemodynamic support.

scholarly journals Microbiome on the Bone-Anchored Hearing System: A Prospective Study

2019 ◽  
Vol 10 ◽  
Author(s):  
Tim G. A. Calon ◽  
Margarita Trobos ◽  
Martin L. Johansson ◽  
Joost van Tongeren ◽  
Malieka van der Lugt-Degen ◽  
...  
Keyword(s):  
Prospective Study ◽  
System A ◽  
A Prospective Study ◽  
Hearing System

scholarly journals Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thiago Ferreira de Souza ◽  
Thiago Quinaglia Silva ◽  
Lígia Antunes-Correa ◽  
Zsofia D. Drobni ◽  
Felipe Osório Costa ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Right Ventricular ◽  
Ventricular Remodeling ◽  
Interstitial Fibrosis ◽  
Systolic Dysfunction ◽  
Extracellular Volume ◽  
Increased Risk ◽  
Tissue Characteristics ◽  
A Prospective Study

AbstractThere are limited data on the effects of anthracyclines on right ventricular (RV) structure, function, and tissue characteristics. The goal of this study was to investigate the effects of anthracyclines on the RV using cardiac magnetic resonance (CMR). This was a post-hoc analysis of a prospective study of 27 breast cancer (BC) patients (51.8 ± 8.9 years) using CMR prior, and up to 3-times after anthracyclines (240 mg/m2) to measure RV volumes and mass, RV extracellular volume (ECV) and cardiomyocyte mass (CM). Before anthracyclines, LVEF (69.4 ± 3.6%) and RVEF (55.6 ± 9%) were normal. The median follow-up after anthracyclines was 399 days (IQR 310–517). The RVEF reached its nadir (46.3 ± 6.8%) after 9-months (P < 0.001). RV mass-index and RV CM decreased to 13 ± 2.8 g/m2 and 8.13 ± 2 g/m2, respectively, at 16-months after anthracyclines. The RV ECV expanded from 0.26 ± 0.07 by 0.14 (53%) to 0.40 ± 0.1 (P < 0.001). The RV ECV expansion correlated with a decrease in RV mass-index (r = −0.46; P < 0.001) and the increase in CK-MB. An RV ESV index at baseline above its median predicted an increased risk of LV dysfunction post-anthracyclines. In BC patients treated with anthracyclines, RV atrophy, systolic dysfunction, and a parallel increase of diffuse interstitial fibrosis indicate a cardiotoxic response on a similar scale as previously seen in the systemic left ventricle.

293 Enhancing Your Recovery: A Mobile Application for Patients Undergoing Vascular Surgery

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Hodge ◽  
K Pattabathula ◽  
J Jenkins ◽  
M Ogg
Keyword(s):  
Vascular Surgery ◽  
Mobile Application ◽  
Outpatient Appointment ◽  
Healthcare Settings ◽  
System A ◽  
University Of Technology ◽  
Operative Complications ◽  
Remote Consultations ◽  
Healthcare Assessment

Abstract Aim: With increasing demands on the healthcare system, a central (and currently essential) push for remote consultations, and an increasing number of co morbidities in the surgical population, the aim was to create an application that placed the focus on pre-hospital optimisation, education and autonomy – addressing these sector trends to enhance outcomes for patients and ease the burden on healthcare settings. Method After obtaining baseline data, I worked alongside students from the Queensland University of Technology to produce an application suitable for both iOS and android platforms. Results The application has four facets which mirror a patient’s journey from their initial outpatient appointment through to recovery. The application is easy to use, free to download and readily accessible. On opening the application, the user can select their planned operation and navigate along a personalised decision tree. Conclusions The application has been designed to educate and empower a patient to become an active participant in their care, leading to long-term changes in healthcare. Assessment is ongoing but early indications suggest that this will be a valuable tool in optimising outcomes for patients undergoing vascular surgery – leading to fewer post-operative complications and earlier restoration of functional status.

scholarly journals A prospective study on the incidence of sore throat after use of laryngeal mask airway during general anesthesia

2021 ◽  
pp. 102595
Author(s):  
kourosh Farazmehr ◽  
Mohamad Aryafar ◽  
Farshid Gholami ◽  
Giti Dehghanmanshadi ◽  
Seyed Sepideh Hosseini
Keyword(s):  
Laryngeal Mask Airway ◽  
Prospective Study ◽  
General Anesthesia ◽  
Sore Throat ◽  
Laryngeal Mask ◽  
A Prospective Study

scholarly journals The association of bullous pemphigoid with dipeptidyl-peptidase 4 inhibitors: a ten-year prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vaia Lambadiari ◽  
Aikaterini Kountouri ◽  
Foteini Kousathana ◽  
Emmanouil Korakas ◽  
Georgios Kokkalis ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Prospective Observational Study ◽  
Dipeptidyl Peptidase ◽  
Dermatology Department ◽  
Steroid Administration ◽  
Dipeptidyl Peptidase 4 ◽  
Increased Risk ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
A Prospective Study

Abstract Background Bullous pemphigoid is the most common bullous chronic autoimmune skin disease. Recent studies have suggested dipeptidyl-peptidase 4 inhibitors as possible predisposing agents of bullous pemphigoid. The objective of our study was to prospectively estimate the association between gliptins and the development of bullous pemphigoid. Methods We conducted a prospective study which included all patients diagnosed with biopsy-proven bullous pemphigoid in the Dermatology Department of our hospital between April 1, 2009 and December 31,2019. The diagnosis of bullous pemphigoid was based on specific clinical, histological and immunological features. Results Overall 113 consecutive patients (age 75 ± 13 years, 62 females) with the diagnosis of bullous pemphigoid were enrolled. Seventy-six patients (67.3%) suffered from type 2 Diabetes and 52 (46%) were treated with dipeptidyl-peptidase 4 inhibitors. The most frequent prescribed gliptin was vildagliptin, being administered to 45 cases (39.8% of total patients enrolled, 86.5% of the patients treated with gliptins). Gliptins were withdrawn immediately after the diagnosis of bullous pemphigoid, which together with steroid administration led to remission of the rash. Conclusions This study revealed that treatment with dipeptidyl-peptidase 4 inhibitors, especially vildagliptin, is significantly associated with an increased risk of bullous pemphigoid development.

CD4/CD8 ratio improvement in HIV-1-infected patients receiving dual antiretroviral treatment

2019 ◽  
Vol 30 (7) ◽  
pp. 656-662 ◽  
Author(s):  
Marta Monsalvo ◽  
Alejandro Vallejo ◽  
María Fontecha ◽  
María J Vivancos ◽  
Pilar Vizcarra ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Ratio Increase ◽  
Related Factors ◽  
Cd4 Cell Count ◽  
Lower Baseline ◽  
Baseline Values ◽  
A Prospective Study ◽  
Aids Diagnosis ◽  
Cd4 Cell ◽  
Hiv 1

The CD4/CD8 ratio is an indirect marker of immune activation, immune senescence, and inflammation in HIV infection. We performed a prospective study of the CD4/CD8 ratio evolution in 245 virally-suppressed (median, 55 months) HIV-infected patients (29% females) who had switched to four dual antiretroviral regimens. At baseline, the median CD4/CD8 ratio was 0.71 (interquartile range, IQR, 0.46–0.97), associated with duration of HIV infection, nadir CD4+ cell count, and AIDS diagnosis. It was lower in the case of hepatitis C virus coinfection and cardiovascular disease (p = 0.09), but the ratio was higher in patients with chronic kidney disease, proteinuria, or osteoporosis. At 48 weeks, the median CD4/CD8 ratio increased by 3% (+0.02; IQR, –0.07, +0.09; p = 0.07); greater improvement was observed in patients with lower baseline ratios and previous AIDS diagnosis. The slope of increase was slower in patients with the highest baseline values. Also, there were no differences in the CD4/CD8 ratio increase according to type of dual regimen, after adjusting for baseline and HIV-related values. In conclusion, CD4/CD8 ratio increase is observed during suppressive dual regimens, and its extent is related to baseline values and previous HIV-related factors. Longer duration on antiretroviral therapy and drug toxicity could affect the evolution of this marker in the presence of comorbidities.

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